Don’t let the Kentucky case fool you. Medicaid waivers aren’t going anywhere. And they will likely include onerous work requirements and prohibit retroactive enrollment.
It’s tough to be sick and poor and in Florida. It’s almost as tough to be a FQHC or CHC that serves the sick and poor in Florida.
If you don’t think about it too hard, it may make sense: Require able-bodied Medicaid recipients to work. So the Trump Administration policy that allows states to revoke Medicaid coverage from certain adult Medicaid enrollees who don’t meet employment requirements may seem sound.
When Congress finally approved the Section 330 Grants under the Bipartisan Budget Act of 2018 benefiting CHCs and FQHCs in early February, there was a collective sigh of relief within many centers. With that Congressional approval, centers now have two years of extended funding, including $600 million dollars to support operations and address unmet need in their communities; plus workforce support through The National Health Service Corps and the Teaching Health Centers Program. But it had been a long nearly 5 month period since the grants had expired, and it would take some time to reverse the damage done in many communities that lost services and other resources. According to The Kaiser Family Foundation, Many considered layoffs, reducing center hours and 20% of centers had instituted hiring freezes, with a total of 45% considering freezes. 25% canceled or delayed renovation/expansion plans that were much needed in the process of providing care.
Organizations that care for Medicaid patients and the underserved often end up with substantial self-pay write-offs. After all, FQHCs and other safety-net organizations don’t turn anyone away—their mission is providing high-quality care to all, regardless of insurance status or ability to pay.