A top Trump administration health official has pointed out why the current Medicaid system in the Affordable Care Act isn’t effective.
It was never meant to be used for able-bodied adults with low-incomes. Instead, it was designed for disabled people.
“One of the major fundamental flaws in the Affordable Care Act was putting in able-bodied adults into a program that was designed for disabled people,” said Seema Verma, the Centers for Medicare and Medicaid Services administrator. “It stretched the safety net and it jeopardizes care for the individuals that the program was originally intended for.”
31 states made the decision to expand Medicaid services and made it available for low-income residents. These programs are funded significantly from the federal government.
Verma has led efforts to overturn the health law since it was passed in 2010.
She plans to work with states that want to implement more conservative features into their Medicaid programs, like requiring that beneficiaries work or take job training in order to receive Medicaid benefits.
Democrats criticize these type of requirements and claim that they evidently prevent individuals from enrolling in these programs.
“Administrator Verma’s plans for Medicaid are grounded in misguided conceptions of the Medicaid program and would send us backward,” said Rep. Frank Pallone, who is also on the House Energy and Commerce Committee.
However, Verma argues that the current Medicaid has to be revamped in order for it to be sustainable and for people to “rise out of poverty and government dependence.”
“These are individuals who are physically capable of being actively engaged in their communities, whether it be through working, volunteering, going to school or obtaining job training,” said Verma in a recent speech to the National Association of Medicaid Directors. “Let me be clear to everyone in this room: We will approve proposals that promote community engagement activities.”
Verma argues that the law doesn’t benefit who it is really meant for. By offering able-bodied adults Medicaid, it resulted in “stretching the safety net for some of our most fragile populations.”
But, unlike the Obama administration, her agency will be letting state governments decide what Medicaid improvements to introduce.
“Our job is to respond to state requests. You won’t see us necessarily impose things on states, whether it’s community engagement or cost-sharing responsibilities. We think it’s important for states to figure out what’s going to work best for them. We’re responding to what they want to do. What you will not see from us is a top-down approach forcing states to do things that may or may not work, or may or may not be appropriate for them,” said Verma.
The average monthly enrollment in Medicaid has climbed to 77 million people, a number that has spiked by roughly 33% since the ACA was signed in 2010.