Year in Review: Medicaid reform takes a back seat to COVID-19

It was supposed to be the year of Medicaid reform, but 2020 became the year of COVID-19.

In prior years, CMS Administrator Seema Verma made Medicaid work requirements a key part of her agency’s agenda. But work requirements aren’t in effect anywhere. A federal appeals court delivered a blow to work requirements in February when a three-judge panel ruled CMS shouldn’t have approved Arkansas’ waiver because the agency didn’t consider how it would affect coverage.

Then the COVID-19 pandemic drove Medicaid work requirements further underground, as the economy collapsed, and Congress forced states to keep beneficiaries on their Medicaid rolls to get extra federal money. The Trump administration recently approved new waivers. But they might never take effect if the Supreme Court strikes down work requirements or President-elect Joe Biden’s administration revisits them.

It was supposed to be a big year for Medicaid block grants too, but most of the efforts didn’t go anywhere.

March 13: President Donald Trump declares a national emergency in response to the COVID-19 pandemic.

March 30: CMS announces sweeping regulatory relief in response to the COVID-19 pandemic.

April 31: Federal social-distancing guidelines expire, leaving states to decide how to control the virus.