Massive omnibus package delivers health wins for both parties

The new government spending bill would allow states to begin reevaluating who is eligible for Medicaid insurance as of April, untethering enrollment from the COVID-19 public health emergency in a win for GOP lawmakers and governors.

State Republicans complained to President Biden that a continuous-enrollment provision had forced them to keep people into the insurance program for the poor until the end of the formal COVID-19 emergency in exchange for enhanced federal funding.

Now, states can begin reevaluating people after the end of March so long as they follow certain guardrails. The enhanced federal matching funds, or Federal Medical Assistance Percentage, will be gradually phased out through 2023, according to a bill released by Rep. Rosa DeLauro, Connecticut Democrat and a top House appropriator, early Thursday.

"Phasing out the #Medicaid enhanced FMAP after the end of the continuous enrollment provisions could provide fiscal support to states during the unwinding period," tweeted Robin Rudowitz, director of the program on Medicaid and the uninsured at the Kaiser Family Foundation.

GOP governors said their share of costs for the federal-state insurance program was starting to balloon alongside enrollment that increased by nearly 20 million since the start of the pandemic.

Some people pivoted to job-based insurance or purchased coverage on the individual market, so they wanted to reevaluate eligibility and kick out persons who no longer needed public coverage.

The Public Health Emergency (PHE) tied to COVID-19 expires in January, but there is a widespread belief it will be extended another 90 days into April, so Republicans pressed for congressional action to sever Medicaid enrollment from the virus designation.

Democrats also pointed to health wins in the $1.7 trillion omnibus, which lawmakers released overnight after tough negotiations to fund the government through September.

Lawmakers had been scrambling to keep federal operations running and avoid a Christmas-period shutdown.

The massive legislation would lock in a provision that allows states to provide new mothers with a year of Medicaid coverage, so postpartum care is covered.

Also, the bill would prevent states from kicking children off Medicaid or the Children’s Health Insurance Program for 12 continuous months, even if a family’s income changes.

“Because of this bill, nationwide, every child in Medicaid and CHIP – 40 million kids across America – will be guaranteed a full year of coverage when they enroll,” Sen. Ron Wyden, Oregon Democrat, said.

The bill also would lock in federal matching funding of 76% for Puerto Rico’s Medicaid program and 83% for other territories, which are treated differently under the program than states.

Retiring Sen. Roy Blunt, a Missouri Republican who focused on health funding, boasted the National Institutes of Health will receive $47.5 billion, a year-over-year increase of $2.5 billion as it eyes breakthroughs on Alzheimer’s disease, cancer and amyotrophic lateral sclerosis, or ALS.

“The medical research community is on the verge of breakthroughs that will transform healthcare delivery and help millions of people live longer, healthier lives,” Mr. Blunt said. “I’m proud that we have been able to establish a sustained, bipartisan commitment to increasing funding for the National Institutes of Health and hope that pattern will continue in the years ahead.”

The funding deal includes $5.27 billion for mental health, an $803 million increase, as lawmakers and Mr. Biden seek to put behavioral health care on par with physical care.

It includes $4.9 billion, a nearly $300 million increase, for substance abuse prevention as the opioid and drug overdose crisis continues to kill tens of thousands of people per year.

For more information, visit The Washington Times COVID-19 resource page.