Administration Rejects Proposal For Lifetime Medicaid Cap

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We have a better sense now of what Medicaid may look like in the Trump era. The president has wanted to give states more flexibility on the government-run insurance for low-income people, and individual states have been proposing changes to Medicaid. The administration's latest responses are telling, as NPR's Selena Simmons-Duffin reports.

SELENA SIMMONS-DUFFIN, BYLINE: The first decision came on lifetime caps. Kansas wanted to cut off Medicaid benefits for some people after three years. Yesterday at a meeting of the American Hospital Association, Seema Verma, who runs Medicaid, made clear she wants states to have lots of flexibility. Then she said this.

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SEEMA VERMA: We are also determined to make sure that the Medicaid program remains a safety net for those that need it most. And to this end, we have determined that we will not approve Kansas' recent request to place a lifetime limit on Medicaid benefits for some beneficiaries.

SIMMONS-DUFFIN: In Kansas, the number of adults eligible for Medicaid is already pretty small, mostly the elderly and disabled.

LOUISE NORRIS: Nondisabled adults who don't have minor children are not eligible for Medicaid at all in Kansas no matter how low their income is.

SIMMONS-DUFFIN: Louise Norris, who writes about health care policy for healthinsurance.org, says the cap would have only affected parents of young kids with extremely low incomes.

NORRIS: If you have a household of three people, like a single parent with two kids, you're talking $8,000 a year in total income.

SIMMONS-DUFFIN: The rejection of lifetime caps in Kansas sends a clear signal to the handful of other states that have similar proposals pending. Later in the day, there was another decision on Medicaid in another state, New Hampshire.

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UNIDENTIFIED REPORTER: State winning federal approval for its plan requiring able-bodied adults to go to work, attend school or perform community service for at least 20 hours per week.

SIMMONS-DUFFIN: That's from Fox News. This wasn't a big surprise. New Hampshire is the fourth state to receive an approval like this. Joan Alker says the double decisions on Kansas and New Hampshire was probably planned. She runs the Georgetown University Center for Children and Families.

JOAN ALKER: The fact that they rushed them out together suggests that they wanted to quickly get back to their message of states know best.

SIMMONS-DUFFIN: What wasn't determined yesterday was Kansas's proposal to add work requirements. All of the states that have already gotten that approval so far expanded eligibility for Medicaid under the Affordable Care Act. If Kansas' request gets approved, Alker says lots of adults there would lose coverage.

ALKER: You have a parent who if they met the work requirement, their income would be too high, and they'd lose Medicaid. And if they don't meet the work requirement, they get kicked off.

SIMMONS-DUFFIN: Other states that didn't expand Medicaid and also want a work requirement are watching closely. Selena Simmons-Duffin, NPR News. Transcript provided by NPR, Copyright NPR.