Trump administration to allow lifetime limits on Medicaid, coverage for thousands at risk

The proposal is the latest in a line of attempts to dismantle the safety net program.

Seema Verma (R) speaks during a swearing-in ceremony, officiated by U.S. Vice President Mike Pence (L), in the Vice President's ceremonial office at Eisenhower Executive Building March 14, 2017. CREDIT: Photo by Alex Wong/Getty Images
Seema Verma (R) speaks during a swearing-in ceremony, officiated by U.S. Vice President Mike Pence (L), in the Vice President's ceremonial office at Eisenhower Executive Building March 14, 2017. CREDIT: Photo by Alex Wong/Getty Images

The Trump administration is taking aim at Medicaid yet again, specifically with lifetime coverage limits, according to a McClatchy report Monday evening.

Just weeks after unveiling guidance that will allow states to impose Medicaid work requirements, Trump’s Health and Human Services agency is reportedly attempting to limit the number of months adults have access to the safety net program. The cap, if approved, would be the first of its kind in Medicaid’s history.

Medicaid, which is jointly funded by states and the federal government, provides health insurance to low-income and disabled people. Steps to cap benefits are another attempt in a long line of crack-downs by the Trump administration, which hopes to reduce the government’s obligation to help the needy.

Since Trump took office, the administration has worked to slash the safety net program in its attempts to repeal the Affordable Care Act (ACA) and through federal waivers. The lifetime coverage limit is the latest federal waiver proposal, which the administration and their allies claim would allow states more flexibility and encourage fiscal responsibility for both governing entities and those who are covered by the program.

In reality, many of the federal waivers mean that thousands of people will lose vital coverage.

Last month, the administration approved waiver requests from Indiana and Kentucky, allowing them to impose work requirements, but five states — Arizona, Kansas, Utah, Maine, and Wisconsin — want to take that a step further by implementing the aforementioned lifetime limits as well.

Arizona and Utah are both seeking a five-year lifetime limit on Medicaid coverage. Utah’s restrictions would apply only to childless adults and would come “with the expectation that [recipients] do everything they can to help themselves before they lose coverage,” McClatchy reported.

In Arizona, the time limits would only accrue during periods in which Medicaid recipients do not meet work requirements. Wisconsin wants to limit coverage for childless adults to 48 months; Kansas wants to limit its coverage of childless adults to 36 months.

Maine seeks to limit Medicaid coverage to three months in any 36-month period, restrictions which would apply if recipients aren’t meeting the program’s work requirements.

In Utah, Kansas, and Wisconsin, the time limits would apply even those recipients who meet work requirements.

The Trump administration’s proposal has raised red flags, even for some Republicans. Gail Wilensky, who ran the Medicaid program for two years under President George H.W. Bush, told McClatchy that she thinks the administration needs to be “very thoughtful” about Medicaid in a way that is different than other cash-based safety net programs.

“It depends on what the safeguards and defaults are in a program like this,” she said of the lifetime limits proposal. “Otherwise it does not make a lot of sense and seems to be cruel and inappropriate.”

Rep. Gwen Moore (D-WI) summed up her take on the Trump administration’s goals for Medicaid in an interview on Monday, telling ThinkProgress’ Amanda Gomez that its decision to implement work requirements in particular is “very clearly a budgetary scheme to reduce the state’s obligations to low-income and poor people.”

“It’s important for people out there to understand that they should not buy into the narrative that these are just lazy bums that refuse to work,” she said. “Most of the people on Medicaid, who are eligible to or who are capable of working, work but they are just too poor to pay for health care, and this will just increase their misery and may even hurl them deeper into poverty.”

The administration sees things differently. In a Sunday op-ed for the Washington Post, Centers for Medicare and Medicaid Services (CMS) administrator Seema Verma wrote that she believes the Medicaid program should be viewed as a path out of poverty.

“We believe that if Medicaid is going to be used as the vehicle to offer substantial taxpayer benefits to healthy, working-age Americans, then we must allow the program to be more flexible,” Verma wrote. “We recognize that states are closer to the people they serve and can better help recipients rise out of poverty.”