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Center for Medicare and Medicaid Services Letter
TAPD is committing to ensuring every Texas child has a change at optimal oral health. That is why we recently signed on to the following letter to the Center for Medicare and Medicaid Services (CMS) to highlight concerns for its recent guidance allowing states to apply for a waiver to set caps in their Medicaid programs.
Dear Administrator Verma:
As leading national, state, and local organizations, representing health care consumers and patients, providers, and other stakeholders, we are writing in strong opposition to recent guidance from CMS, Healthy Adult Opportunity, which allows states to fundamentally change the nature of their Medicaid programs. We urge the Administration to rescind this guidance, which could hurt millions of families that rely on Medicaid.
Medicaid is an essential source of coverage for over 70 million people. Medicaid’s current state-federal partnership helps states provide quality health insurance to their residents –it ensures that children are able to get a healthy start in life, provides long-term care to seniors and people with disabilities, and vital health care for many adults including pregnant women. The current state-federal funding structure provides states and taxpayers a level of financial security, ensuring that as Medicaid spending fluctuates from year to year, the state and its taxpayers are not made solely responsible for covering any increased costs. Efforts to restructure or cut Medicaid would shift health care costs to the states, hurt local economies, and threaten care and coverage for millions.
The Administration’s long-anticipated State Medicaid Director Letter, which was published on January 30, encourages states to adopt caps on their federal Medicaid funds voluntarily under a Medicaid section 1115 demonstration waiver. This arrangement involves major fiscal risk for states; the “flexibility” states will have is to cut services or take away coverage if and when they hit their new federal funding cap. Capping and restructuring Medicaid would create an awful choice for states in the event of increasing health care costs. Once that happens, the state will start rolling back coverage for kids, people with disabilities, and seniors and cost-effective optional benefits like dental care, without oversight.
Further, the Administration does not have jurisdiction to waive Medicaid’s financing structure through the 1115 waiver process. Such a fundamental change to Medicaid’s structure requires a change in statute and therefore an act of Congress. In 2017, when Congress considered federal funding caps, millions of people from around the country raised their voices in opposition, and lawmakers rejected the proposal on a bipartisan basis.
We urge the Administration to rescind this guidance that promises flexibility, but will surely lead to catastrophic implications for state budgets, and state Medicaid programs and the communities they serve. We implore you to reconsider this proposal, and protect the children, seniors, people with disabilities, women, parents, people of color, and working families that rely on Medicaid for health care.