Mar 5, 2018

CMS punts on controversial plan to roll back Medicaid expansion

CMS Administrator Seema Verma. Photo: Jabin Botsford/The Washington Post via Getty Images

Federal health officials approved a new set of Medicaid work requirements today — this time in Arkansas — but punted on the state’s more aggressive proposal to roll back the Affordable Care Act’s Medicaid expansion.

Why it matters: The Trump administration has made clear that it will help states pare back their Medicaid programs. But the split decision today in Arkansas suggests there may be limits to how far it’s able or willing to go.

The details: The ACA offered states generous federal funding if they expanded their Medicaid programs to cover all residents with an income below 138% of the federal poverty limit.

  • Arkansas chose to expand, but now wants to roll back eligibility to 100% of the poverty limit — while keeping the enhanced federal funding.
  • The federal Centers for Medicare & Medicaid Services did not make a decision about that proposal today, even as it announced it had approved Arkansas’ request to add a work requirement to its Medicaid program.
  • Arkansas is the third state to win approval for work requirements, following Kentucky and Indiana.
  • Arkansans who don’t meet the new work requirements for three months will be locked out of the program for the rest of the calendar year. That’s the longest lockout period CMS has approved.

Go deeper

Nikki Haley poaches top conservative from Heritage Action

Photo: John Lamparski/Getty Images

Nikki Haley has hired Tim Chapman, the head of Heritage Action, to run her conservative policy group Stand For America, according to two sources with direct knowledge of the hire. Haley and Chapman confirmed the hire, which was first reported by RealClearPolitics' Philip Wegmann.

Why it matters: Chapman is among the most influential conservative policy leaders in the country. His hire is Haley's highest-profile outside recruitment since leaving her job as UN ambassador under President Trump.

Situational awareness

Photo: Scott Olson/Getty Images

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  4. National polls show Bernie in control ahead of Nevada
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Trump has declared war on sanctuary cities

Illustration: Sarah Grillo/Axios

Armed with subpoenas, lawsuits and immigration SWAT teams, the Trump administration has declared war on sanctuary cities.

The big picture: President Trump and his administration have used every available tool to try to crack down on local governments that refuse to hold immigrants in criminal custody, block immigration agents from working in county jails or deny federal authorities access to immigrants' records.