This week, JLF’s Mitch Kokai was quoted in a Winston-Salem Journal story on Medicaid expansion. The reporter, Richard Craver, writes:
A federal oversight agency cautioned last week that the Centers for Medicare & Medicaid Services (CMS) may not be properly monitoring administrative expenses related to its work requirement exemption for Medicaid expansion states.
The Government Accountability Office (GAO) report, released Thursday, measures the estimated expenses in five of the nine states that have received Trump administration CMS approval for a work requirement of between 80 to 100 hours monthly.
Craver summarized the findings of the report:
…The GAO said it “found weaknesses in CMS’ oversight of the administrative costs of demonstrations with work requirements.”
- The weaknesses fall into two main categories:
No consideration of administrative costs during approval.
“GAO found that CMS does not require states to project projections of administrative costs when requiring demonstration approval,” according to the report.
“Thus, the costs of administrating demonstrations, including those with work requirements, is not transparent to the public or included in CMS’ assessments on whether a demonstration is budget neutral.”
- Current procedures may be insufficient to ensure that costs are allowable and matched at the correct rate.
The article includes JLF’s Mitch Kokai’s comments on the findings. Kokai states that these findings do not give much insight into the validity of work requirements, such as those proposed in N.C. House Bill 655:
Kokai said the GAO report focuses on the proper use of federal funds and the desire to minimize waste and abuse.
“It takes no stand on the policy question of whether work requirements make sense,” Kokai said. “So, the report offers N.C. policymakers minimal help in deciding how to proceed with this state’s Medicaid program.”
“…If Medicaid overseers in Washington believed that the administrative costs of work requirements could take up too much of the program’s funding, it’s likely that they would have concurred with GAO’s findings,” Kokai said.