A PSA. Given that Joseph Kishore, editor of wsws has given me permission to use all their content i'd like, i'll post in half of this lengthy exposé and allow you to read the rest.

I never did discover whether or not this would be done by executive order or what, or simply accomplished thru his Dept. of Health and Human Services. The other question is always which, and how many docs, accept medicaid, and iirc some states allow medicaid to pay for extended care for seniors (or did).

from Kate Randall, 1 February 2020, wsws.org:

"On Thursday, the Trump administration unveiled a change in the Medicaid program that will potentially slash benefits for millions of recipients, while opening the door for a broader assault on other entitlement programs, including Social Security and Medicare. The announcement received little attention in Washington, which is fixated on the Trump impeachment trial in the Senate.

Medicaid, a health program jointly administered by the federal government and the states, currently covers one in five Americans. There are currently 72.4 million individuals enrolled in Medicaid or the Children’s Health Insurance Program (CHIP). The Trump proposal would allow states to cap Medicaid spending for poor adults without children, many of whom gained coverage through the expansion of the program under the Affordable Care Act (ACA).

This dramatic change would allow states to convert a portion of Medicaid funding into block grants, received in one lump sum or on a per-enrollee basis, thus capping funding. It would incentivize states to cut Medicaid spending by allowing them to recoup the unspent portion of the block grants to be used as they please. To reduce spending, states would be granted flexibility in imposing co-payments and cutting benefits and services.

The “Healthy Adult Opportunity” initiative, as it is known, would be sanctioned only for adult beneficiaries younger than 65 who are not eligible for Medicaid due to pregnancy, a disability or a need for long-term care. However, states could also decide to include certain pregnant women or adults with children because their coverage is not mandated by federal law. The switch to the new model would be optional, and states would have to seek authority from the federal government to implement its features.

Medicaid was expanded under the ACA in 2014 to cover all US citizens and legal residents with income up to 133 percent of the poverty line, including adults without dependent children. Thirty-six states have so far expanded Medicaid to cover these poor adults, increasing Medicaid enrollment by 13.1 million.

The federal government covered the full cost of the expansion in 2014, reducing the federal government’s share yearly by increments down to 90 percent of coverage beginning in 2020 and for all subsequent years. By contrast, the federal government generally pays between 50 and 77 percent of a state’s total Medicaid costs, depending on the state’s resources. Trump’s new policy openly takes aim at the funding for Medicaid expansion by attacking coverage and benefits for those who have gained coverage.

Seema Verma, the administrator of the federal Centers for Medicare and Medicaid Services (CMS), has long lobbied for “transforming” Medicaid. In January 2018, she led the push to allow states to require Medicaid recipients to work or get job training. As of 2019, 15 states had either received or were waiting for CMS authorization to impose the work requirements.

Before the work requirements were challenged in court, thousands had been thrown off the rolls, including nearly 18,000 in Arkansas, the first state to institute the requirements. According to the Kaiser Family Foundation (KFF), if work requirements were imposed nationwide, between 1.4 million and 4 million people could lose their Medicaid coverage. The Trump administration is currently fighting numerous court battles over the work requirements.

In a call with reporters, Verma said that those Medicaid enrollees gaining coverage through the program’s expansion under the ACA include adults who may be healthy and with adequate income to cover expenses. She said that Medicaid “was not originally designed for this group” and that many states had been “far too lax” in verifying whether people were even eligible for benefits. The CMS administrator said her motivation for the policy change was the government’s “solemn responsibility to provide for the most vulnerable among us.”

the rest is here.

‘Healthy Adult Opportunity Fact Sheet’, Jan 30, 2020, cms.gov

‘Healthcare Associations React Negatively to CMS’s “Healthy Adult Opportunity” Announcement’; The immediate reaction of the nation’s leading healthcare professional associations, on both the provider and health plan sides, to CMS’ “Healthy Adult Opportunity” program announcement, was almost entirely negative, Feb 3, 2020, health care innovations group