CMS announces plans to deny Medicaid waivers for continuous eligibility, job training programs

The Centers for Medicare & Medicaid Services (CMS) is shifting its policy on Section 1115 Medicaid waivers, the agency announced this week (Source: “CMS warns states of new Medicaid waiver expectations,” Fierce Healthcare, July 17).
 
In letters to states released Thursday, the agency said it won’t extend or grant waivers for continuous eligibility in Medicaid or the Children’s Health Insurance Program (CHIP).
 
Additionally, separate letters informed states that programs using Medicaid funds for job training or employment-related activities will see the same fate. These initiatives include strengthening primary care, behavioral health, dental care and home- and community-based services.
 
“For too long, Medicaid and CHIP have drifted away from their core mission of providing a safety net for the truly vulnerable—that ends now,” said CMS Administrator Mehmet Oz, MD, in a statement. “CMS is restoring commonsense guardrails to Medicaid and CHIP, which will ensure that Medicaid remains a lifeline for those who are eligible and in need of quality health care.”
 
Under the Biden administration, the CMS approved waivers, as recent as November, allowed states to provide extra years of eligibility for children beyond the 12 months required by federal law. In several states, continuous eligibility was given for recently incarcerated individuals.
 
The previous administration argued this policy aided states in reducing administrative burden and helped families maintain healthcare coverage, even when they were suddenly ineligible after a change in income, for example. They pointed to evidence showing coverage leads to better health and educational outcomes, resulting in greater tax revenue and less reliance on federal programs.