What's "shady" is the quiet way the
The nation's governors are warning that consequences could be severe.
That's especially true in
Nationally, one in five Americans is covered by Medicaid; in
The federal government pays 60% of the cost of Medicaid; states pick up the rest, and they rely on a variety of funding mechanisms that allow them to leverage federal matching funds and expand the coverage they can offer their residents. In
Among those are "provider taxes" on hospitals, nursing homes and insurance companies that get invested back into Medicaid. The providers generally support these taxes because they wind up getting more revenue back in payments on behalf of patients than they put in.
Also targeted in the proposal are payments from local governments to a state that also help leverage federal matching dollars, along with supplemental payments to hospitals that treat large numbers of low-income patients.
The Trump administration, which has tried to repeal the Obama-era expansion of Medicaid, says it will review 4,000 comments it received on the proposal before a final decision. CMS says the cost of the proposal is "unknown," but it disputes the results of a study done on behalf of the
An agency that says in its own proposal that it doesn't know the cost has no business dismissing anyone else's estimates.
At a minimum, the administration should go back to the drawing board and conduct a full study of the ramifications of its proposed rules before proceeding, something it apparently has not done. Other interested groups, including the
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