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Flexibility is mentioned 8 times in this short fact sheet. It sounds harmless enough, so what is the big deal? Well, look at what the flexibility will be used for. Most of these things represent additional burdens on Medicaid beneficiaries or reductions to the Medicaid program.pic.twitter.com/8StmfplhKI
"cost sharing" = #Medicaid beneficiaries pay
"aligning benefits"= they get fewer things covered "programmatic adjustment" = administrative burdens that make benefits harder to get
"applying conditions"= fewer people are eligible
"wavering retroactive coverage"= less coveragepic.twitter.com/5mnGfv6QmA
Nearly every aspect of the "flexibility" that CMS so giddily touts is about states having the power to take away benefits, exclude beneficiaries and make the whole system/process harder for the people it is meant to help.
Here is the glaring indicator that CMS knows full well that this "flexibility" is not in the best interest of Medicaid beneficiaries: they limit the program to the least sympathetic populations. They only want to do this to the folks they think don't "deserve" health care.pic.twitter.com/HwBwHdbdnS
If CMS truly believed that this program was in the best interest of beneficiaries, why not apply it to everyone? Thank goodness they do not, of course. But the choice reflects a narrative that Verma's CMS has consistently pushed: only the most sympathetic are "deserving" of care
In addition to a false narrative of deservingness this program pushes another agenda as well, one with a long history: removing Medicaid's status as an entitlement, capping its funding & undermining its ability to help everyone who is eligible (i.e. block granting it).pic.twitter.com/hQbgXK2rvG
Don't be fooled by the pretense of "performance indicators" as a mechanism for accountability. What are the baseline expectations for these indicators? What will happen if indicators show people are being harmed? What about the voice and perspectives of actual beneficiaries?pic.twitter.com/2ol2On1Ydm
Despite the anodyne & euphemistic language CMS uses to describe the "Healthy Adult Opportunity" program this is about making healthcare harder to get for folks on the margins & asserting healthcare as a privilege, not a right. If you're against that, then you're against HAO. /END
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