Understanding Harmful Federal Proposals and Advocating to Protect Medicaid

The new administration in Washington and some members of Congress have proposed drastic changes to the Medicaid program.  Advocates and others believe Medicaid block grants, per-capita caps, work requirements and new cost-sharing measures would be devastating to state Medicaid programs, Medicaid consumers, and the safety-net providers that serve them.

Enhancing and Protecting Medicaid During Coronavirus Response

As part of its response to the coronavirus, the federal government has enacted a temporary increase in the federal share of Medicaid (FMAP). New York typically gets a 50 percent federal share; during the coronavirus public health crisis the share has been increased to 56 percent. In order to be eligible for the enhanced FMAP, all states are held to a Maintenance of Effort (MOE) provision that prohibits states from making changes to their Medicaid program. Changes in eligibility or benefits cannot occur while a state is receiving enhanced FMAP (currently planned through the end of October, but likely to be extended in subsequent federal relief efforts). Several of this year’s enacted budget provisions are in violation of the MOE tied to receipt of the temporary FMAP increase. In order for New York to receive the enhanced FMAP the budget allows the Governor to delay implementation of any provision until 90 days after the State COVID-19 disaster emergency declaration expires.

It is critically important for the MOE to remain in place. Governor Cuomo has urged Congress to remove the MOE to allow him flexibility in making cuts to Medicaid. Doing so would put any Medicaid program in peril, not just in New York.

Several national advocacy groups have been pushing Congress to retain the MOE, including Community Catalyst and FamiliesUSA. Medicaid Matters has signed their letters to Congress and has encouraged coalition members to do the same.

Dozens of New York advocacy groups and organizations signed on to a letter regarding Medicaid and the importance of the MOE to the New York Congressional delegation from the New York chapter of Health Care for America Now (HCAN).  The letter is available here.

Here is media coverage on the New York-specific Medicaid MOE exemption in the HEROES Act: Eyeing Medicaid Cuts, Cuomo Puts His Stamp On A $3 Trillion Stimulus Bill (Gothamist, 5/15/20)

Advocates are encouraged to send messages to their own members of Congress to urge the New York-specific Medicaid maintenance of effort (MOE) exemption be removed.  Templates and instructions are available here.

At the end of July 2020, the Senate Majority put out their Coronavirus relief proposal, the HEALS Act.  Medicaid Matters joined Citizen Action of New York, the New York chapter of Health Care for America Now, and the Metro-NY Health Care for All Campaign to put out a statement on the importance of protecting Medicaid and other programs in the next Coronavirus relief package.

National advocacy organization Community Catalyst statement on the HEALS Act is here.

A side-by-side of the House HEROES Act and the Senate HEALS Act by the Progressive Caucus Action Fund is here.

Block Grants and Spending Caps

Work Requirements

Impacts on Children