In a move widely praised by Heritage Foundation health policy experts, the federal government recently approved an important Medicaid waiver for the state of Tennessee. If approved by the Tennessee General Assembly, the waiver would give the state additional program flexibility in exchange for fixed federal funding.
Heritage has long pushed for reforms to the Medicaid program. In a July 2015 report, Nina Owcharenko Schaefer, who serves as senior research fellow for domestic policy studies at Heritage, argued Medicaid was not adequately serving low-income communities.
“Congress needs to reform Medicaid—but Medicaid reform should not be another excuse to create a lifetime of dependence, but to support independence,” wrote Owcharenko Schaefer. “Reform should assist those who are able to shift to a competitive private health insurance market, where coverage is more affordable and thus the need for assistance diminishes.”
Heritage scholars have repeatedly advocated for Congress to adopt a new approach to financing the Medicaid program. The think tank would like to move Medicaid away from open-ended entitlements to a more fiscally predicable and budgeted program that gives states the ability to tailor their program to meet their needs.
In January 2020, the federal government announced its Healthy Adult Opportunity waiver, which allowed states larger amounts of flexibility in the way it used its Medicaid programs. However, the waiver only applied to states that expanded their Medicaid programs under Obamacare.
Owcharenko Schaefer urged the federal government to approve proposals from states like Tennessee that had not expanded their programs under Obamacare, but still wanted to provide their citizens with flexible and lower-cost care.
“State initiatives like those proposed by Georgia and Tennessee build on CMS’s commitment to launch a much-needed reform-minded era for the federal-state health care programs,” wrote Owcharenko Schaefer in a commentary from September 2020.
Approval of Tennessee’s waiver indicates a welcome shift in the federal government’s position on state-based Medicaid initiatives.
“This is a critical first step in reforming the Medicaid program that builds on the principles of state flexibility and fiscal responsibility,” said Owcharenko Schaeffer upon hearing that the waiver had been approved. “But this is only the first step. It’s up to Congress to create a lasting reform platform that puts patients first and gives the states the regulatory relief and resources to make health care more affordable, more accessible and more accountable to their citizens”.
For more information on Heritage’s health care proposals, click here.