CMS Sets a Powerful Precedent Against Malicious Lifetime Limit Medicaid Waivers but Betrays Fundamental Obligations to American Indians and Alaska Natives

Washington, D.C. —The Centers for Medicare and Medicaid Services (CMS) Administrator Seema Verma announced that the Trump administration rejected Kansas’s proposal to implement lifetime limits for portions of their Medicaid population. Separately, she said that CMS hopes to work with states to impose work requirements on American Indians and Alaska Natives.

Following is the statement of Eliot Fishman, senior director of health policy for Families USA:

“The decision on the Kansas time limits proposal that Seema Verma announced today is the right one. CMS should apply this precedent to all state requests to impose time limits on any group of people who get health coverage through Medicaid—including adults who are covered through Medicaid expansion. Time limits in Medicaid are bad law and bad policy, harming people who rely on the program for life-saving health care.

“In contrast, Families USA views the Trump administration’s decision to impose work requirements on American Indians and Alaska Natives as a betrayal of the U.S. government’s long-established treaties and federal law. Tribes have their own governments and health systems that, by statute and treaty, have a direct government-to-government relationship with the United States. States are legally forbidden to impose Medicaid premiums or any other Medicaid cost-sharing on American Indians and Alaska Natives enrolled in Medicaid. Tribes are seeking to be exempted from their states’ foolish and self-destructive policy on Medicaid work requirements and other eligibility restrictions. If states can’t impose premiums or cost-sharing on tribal governments, they can’t impose waivers that take coverage away entirely.”

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