Republicans Push Ahead on Medicaid Restrictions

Republicans Push Ahead on Medicaid Restrictions

U.S. President Trump listens to reporters during bill signing ceremony in the Oval Office of the White House in Washington
JOSHUA ROBERTS
By Michael Rainey

The Trump administration on Friday approved Ohio’s request to impose work requirements on Medicaid recipients. Starting in 2021, the state will require most able-bodied adults aged 19 to 49 to either work, go to school, be in job training or volunteer for 80 hours a month in order to receive Medicaid benefits. Those who fail to meet the requirements over 60 days will be removed from the system, although they can reapply immediately.

The new work requirements include exemptions for pregnant women, caretakers and those living in counties with high unemployment rates and will apply only to those covered through the expansion of Medicaid under the Affordable Care Act. There are currently about 540,000 people on Medicaid in Ohio who receive coverage through the expansion, according to Kaitlin Schroeder of The Dayton Daily News, compared to roughly 2.6 million Medicaid recipients in the state overall.

Once implemented, the work requirements are expected to result in 36,000 people losing their Medicaid eligibility, according to state officials, though critics say the reductions could be significantly larger. Similar work requirements in Arkansas pushed 18,000 people off the Medicaid rolls in six months.

A larger GOP project: The creation of new work requirements is part of a larger effort by Republicans to limit the expansion of Medicaid, says The Wall Street Journal’s Stephanie Armour. Since the Affordable Care Act passed in 2010, 36 states have expanded their Medicaid programs under the ACA and the number of people in the program has grown by 50 percent, from roughly 50 million to about 75 million. But many red-state governors have expressed concerns about the cost of Medicaid expansion and worries about a lack of self-sufficiency among the able-bodied poor, and are embracing new limitations on the program for both fiscal and political reasons.  

In 2017, the White House in 2017 gave states the green light to explore ways to limit the reach and expense of their Medicaid programs. Governors have proposed a variety of new rules, which require waivers from the federal government to enact. Kentucky, for example, wants to drug-test Medicaid recipients, and Utah wants a partial expansion and a cap on payments. Kaiser Health News summarizes the variety of waivers states have requested, which are governed by Section 1115 of the Social Security Act, in the chart below. 

Legal challenges: Efforts to restrict Medicaid have received legal challenges, and U.S. District Judge James Boasberg blocked work requirements in Kentucky last year. The same judge, who has expressed doubts about the administration’s approach to Medicaid, will rule on the legality of work requirements in both Kentucky and Arkansas by April 1.

The bottom line: The Trump administration is seeking fundamental changes in how Medicaid works. Even if Boasberg rules against work requirements, expect the White House and Republican governors to continue to push for new limitations on the program.

Hoping for a Raise? Here’s How Much Most People Are Getting

iStockphoto
By Beth Braverman

Nearly all companies plan to give raises to their employees next year, with an average salary bump of 3 percent, the same increase workers received this year, according to a new survey released Monday by Towers Watson.

Raises for executives and management will be 3.1 percent.

“To a large extent, 3 percent pay raises have become the new norm in corporate America,” Sandra McLEllan, North American Practice Leader for Towers Watson said in a statement. “We haven’t seen variation from this level for many years.”

Related: The Real Root of America’s Wage Problem

While the average raise is 3 percent, companies plan to tie the amount of individual raises to worker performance. Employees with the best reviews will receive an average 4.6 percent increase in salary, while workers with below-average ratings will get less than 1 percent.

The survey also found that companies are shifting their compensation packages to include more short-term incentives and bonuses. Eighty-five percent of workers took home a bonus this year, up from 81 percent this year. Nearly 90 percent of exempt employees were eligible for an annual or short-term bonus.

Even as unemployment has finally fallen, wage growth since the Great Recession remains largely stalled. Last month, wages for civilian workers grew just 2.1 percent, according to the Employment Cost Index.

Fed Chair Janet Yellen, who is looking for economic growth before instituting a rate hike, has said that stagnant wages are one factor hampering such growth. After all, consumers can’t increase the amount of goods and services they can purchase if they aren’t increasing their pay.

Top Reads from the Fiscal Times:

When Buying Car Insurance, Young Drivers Should Stick with Mom and Dad

iStockPhoto
By Suelain Moy

The parents of young drivers have enough to worry about, but a new study from insuranceQuotes.com finds that those who add coverage for an 18-to-24-year-old can expect to see an average annual premium increase of 80 percent on their existing car insurance. The good news: That’s still cheaper than if the young drivers bought insurance on their own. If those young drivers were to buy individual plans of their own, they’d pay 8 percent more on average — and in some cases, over 50 percent more — than their coverage costs on a parental plan.

Related: The Shocking Secret About How Your Car Insurance Rate Gets Set

Premiums can vary widely depending on the driver’s age and state. An 18-year-old can expect to pay an average of 18 percent more for an individual policy than he or she would if added to an existing policy. But in Rhode Island, an 18-year-old will pay an average of 53 percent more for an individual policy. In Connecticut and Oregon, the difference is 47 percent.

In states such as Arizona, Hawaii, and Illinois, it actually becomes cheaper, on average, for a young driver to get his or her own policy after turning 19. When it comes to determining premiums, Hawaii is the only state that doesn’t allow insurance providers to consider age, gender, or length of driving experience.

These are the five states with the greatest difference in premiums for young drivers buying their own coverage.

1. Rhode Island: 19 percent
2. Connecticut: 16 percent
3. North Carolina: 14 percent
4. Vermont: 14 percent
5. Maine: 14 percent

Related: Now 16-Year-Olds Can Double Your Car Insurance

And these five states have the smallest difference:

1. Hawaii: No difference
2. Illinois: No difference
3. Arizona: 2 percent
4. Mississippi: 5 percent
5. South Carolina: 5 percent.

Top Reads from The Fiscal Times:

Vladimir Putin’s Cheesy Act of Defiance

Youtube
By Millie Dent

The United States and European Union have been squeezing Russia with sanctions since it annexed Crimea, a territory that previously belonged to Ukraine, in March 2014. In response, Russian President Vladimir Putin established a ban on U.S. and EU foodstuffs a few months later as a snub to the West. 

On Thursday, Russia commemorated a tightening of that year-old ban on Western agricultural products by bulldozing bright yellow blocks of cheese. The country also streamrolled fruit and set piles of bacon ablaze. By midday, 28 metric tons of apples and tomatoes from Poland had been demolished, as well as 40 tons of apricots from an unknown country, according to The Wall Street Journal

Related: Move Over, Santa: Putin Claims the North Pole 

The Western sanctions and a plunging ruble have caused Russian food prices to spike this year. Some politicians, religious leaders and other Russian citizens denounced the destruction of the food, noting that millions of Russians are living in poverty. More than 285,000 people signed an online petition that asked Putin to distribute the food rather than destroy it. 

The Kremlin has promised to help develop Russia’s own agricultural industries and to promote domestic food products that the middle-class generally ignore in supermarkets in favor of status symbols like French cheese and Italian meat. In addition, the Kremlin announced that any contraband foodstuffs found would be destroyed. Russia’s Agricultural Minister Alexander Tkachyov said on state TV that the quality of Western food products could no longer be guaranteed.  

Top Reads from The Fiscal Times: 

This May Be the Best Frequent Flier Perk Ever

The Delta airline logo is seen on a strap at JFK Airport in New York, July 30, 2008. Delta Air Lines Inc on Wednesday announced a award travel structure for its Skymiles frequent flier program.  REUTERS/Joshua Lott (UNITED STATES)
JOSHUA LOTT
By Beth Braverman

Forget about getting bumped up to first class. Delta Airlines is now bumping its best customers off commercial flights entirely -- and onto private jets.

The program got off the ground last week, according to Bloomberg, with its first flight traveling from Cincinnati to Atlanta.

 To be eligible for the upgrade, fliers must have at least 125,000 miles in travel and $15,000 in annual spending with the airline. The bump costs an extra $300 to $800.

In addition to improving the loyalty among some of Delta’s best customers, the program has a side benefit for Delta, allowing it to get some value from positioning flights, known as “empty legs,” which make up about 30 percent of industry flying.

Delta and other airlines have been shifting their loyalty programs in ways that make it easier for elite flyers to earn rewards and more difficult for more irregular customers.

Related: Rethinking airline points strategy with the Points Guy

Starting in June 2016, Delta will issue rewards based on the amount of money spent rather than miles traveled, and the airline may change the number of miles necessary to book a flight based on demand and other factors.

Analysts say that other airlines may follow suit. Airline reward programs have been unsuccessful in fostering loyalty among patrons, many of whom book flights based on cost and convenience rather than brand preference. Only 44 percent of travelers and 40 percent of business travelers fly at least three-quarters of their miles on their preferred airline, reports Deloitte.

Delta’s reward program ranked 9th on U.S. News’ annual ranking of the best airline rewards programs, released this week, receiving 3.1 stars out of 5. Alaska Airlines was ranked first.

You’ve Got to See This GOP Hawk’s Grisly Ad Opposing the Iran Deal

Youtube
By Michael Rainey

A group led by John Bolton, the aggressively hawkish Republican insider who served as George W. Bush's ambassador to the United Nations, has released an unusually grisly ad that vividly portrays a nuclear attack on the United States.

The 30-second video was produced by the Foundation for American Security and Freedom, which Bolton leads. It shows an all-American family of four sitting down to a dinner of pasta and red sauce. The father kindly asks, “How was your day?” As his wife and children enthusiastically reply, a blinding flash rips through the scene to the sound of burning and destruction. The screen fades to black, and then we see and hear Sen. Rand Paul speaking, with his words also written on the screen: “Rand Paul: ‘our national security is not threatened by Iran having one nuclear weapon’.” The screen fades to black again, and then we see a nuclear explosion, with the words: “It only takes one.” As the nuclear cloud boils up into the sky, we see the final message: “A nuclear threat is a threat to our national security.”

The 30-second video seems to consciously mimic Lyndon Johnson's infamous "Daisy" ad from the 1964 presidential election. That ad was widely criticized for using a nuclear explosion to frighten the audience into believing that, if elected, Republican nominee Barry Goldwater would risk all-out war with the Soviet Union. The ad was shown only once (on September 7, 1964) but that proved to be enough.

Several differences between the Bolton group’s ad and “Daisy” stand out. For one, the new ad shows a family being destroyed by a nuclear blast. By contrast, the Johnson ad implied the death of a small girl and many others, but without showing the blast and its victims together.  

Another difference is the target. The “Daisy” ad took aim at a hawkish Republican candidate for president, implying that an aggressive attitude toward a major enemy could lead to the destruction of the world. The Bolton group’s ad takes aim at a dovish Republican candidate — and, by implication, a dovish American president — while suggesting that a diplomatic approach toward a major enemy could lead to war on American soil.

A final difference: The Johnson campaign withdrew the “Daisy” ad as the criticism poured in. The Bolton group’s ad is on the Internet, where it can be seen over and over again. And thanks to the dynamics of social media, it will likely reach a larger audience than “Daisy” ever did — though to what effect, it remains to be seen.

Here’s the Daisy ad: