Arizona: Governor Proposes Premiums, Co-pays, and Work Requirements for Medicaid Program

Governor Doug Ducey (R) plans to submit a waiver request in the fall for a new Medicaid program—called CARE (Choice, Accountability, Responsibility and Engagement)—that would introduce new requirements on most Medicaid expansion enrollees. In addition to co-payments for certain services (capped at 3% of income), CARE would require enrollees to deposit a premium payment equaling 2% of income into a health savings account (HSA), which could then be used for services not covered by Medicaid. Enrollees over 100% of the federal poverty level would be disenrolled for six months for failure to make the CARE payments. The plan requires that members complete one wellness incentive and be employed, attending school, or actively seeking employment. The governor noted his efforts will include legislative initiatives to limit lifetime enrollment in Medicaid to five years and eliminate non-emergency medical transportation. While some elements of the CARE plan have been approved previously in other states, many go beyond what CMS has approved to date.

Pennsylvania: State Completes Transition to Traditional Medicaid Expansion

Governor Tom Wolf (D) announced that Pennsylvania has completed its transition of Medicaid beneficiaries from the alternative Medicaid expansion spearheaded by previous Governor Tom Corbett (R) to “HealthChoices,” a traditional Medicaid expansion program. Nearly 80,000 Pennsylvanians were converted to the new program via data system updates in this final push, and all enrollees who transitioned will have their coverage through the HealthChoices plan begin September 1. The governor also announced that a total of 440,000 individuals are now enrolled through the State’s Medicaid expansion, with 150,000 having enrolled directly in the HealthChoices plan launched at the end of April.

Tennessee: State Applies to Expand Program for Disabled Beneficiaries

Tennessee has requested an amendment to its TennCare II waiver that would allow the State to participate in the Medicaid Buy-In program, under which states may extend coverage to workers with disabilities who have earnings in excess of traditional qualifying incomes. Under Tennessee’s proposed “Employment and Community First CHOICES” program, the State would cover those with family income up to 250% of the federal poverty level. Comments on Tennessee's proposal are due on August 5, 2015.