Medicaid Enrollment Surges to New High

By Yuval Rosenberg

Medicaid Enrollment Surges to New Record Amid Pandemic

A record high of nearly 74 million people were enrolled in
Medicaid at the beginning of 2021, the Centers for Medicare and
Medicaid Services
announced Monday. Including minors enrolled in the
Children’s Health Insurance Program, which covers children in
families who earn too much to qualify for Medicaid, the total comes
to more than 80 million.

Medicaid participation increased sharply as the coronavirus
pandemic hit, CMS said, jumping by 9.7 million between February
2020, the month before a public health emergency was declared, and
January 2021.

The agency said that a rule change adopted by Congress early in
the crisis played a major role in the increase. The Families First
Coronavirus Response Act, passed in March 2020, gave states a
temporary 6.2% increase in Medicaid funding to cover the expected
surge in health care costs, on the condition that they not remove
anyone from the rolls until the pandemic is over.

“The increase we are seeing is exactly how Medicaid works: the
program steps in to support people and their families when times
are tough,” CMS Administrator Chiquita Brooks-LaSure said in a
statement. “For the parents that may have lost a job or had another
life change during the pandemic, having access to coverage for
themselves and their kids is life-changing.”

A change in focus: The increase reversed a trend of
declining enrollment in Medicaid, which had been driven in part by
the former Trump administration’s efforts to impose new
restrictions on participation, The New York Times’s Sarah Kliff

notes.

By contrast,
says Amy Goldstein of The Washington Post, the
Biden administration has focused on expanding federally funded
health care, both through Medicaid and the Affordable Care Act. The
White House has said that it plans to keep the public health
emergency in place at least until the end of the year, which
experts will likely keep the enrollment numbers at or near record
highs.

The Biden administration is also trying to entice the
dozen states that have refused to expand their Medicaid programs as
allowed under the Affordable Care Act, to change their minds. The
American Rescue Plan, passed in March 2021, includes more generous
federal subsidies to cover the state portion of Medicaid costs. So
far, though, there are few signs that officials in the
non-expansion states are moving toward Medicaid
expansion.

Is This, Finally, Infrastructure Week?

This really, finally, could be infrastructure week on
Capitol Hill. Or not. The bipartisan group of 21 senators hammering
out an infrastructure deal is reportedly hoping to finalize its
plan this week. A four-page outline of the proposal is reportedly
circulating. But the roughly $1 trillion plan, including $579
billion in new spending, is still being tweaked, with senators
reportedly set to meet again Monday night.

"We're continuing to work and flesh it out," said Sen.
Susan Collins (R-ME), according to
Politico. "There's a sense of growing optimism,
that perhaps we can show our country and the world that we can come
together on something that makes a real difference in people's
lives."

Some details of the bipartisan deal: Politico reports
that, as of now, the bipartisan blueprint includes “$360 billion
for roads, bridges and major projects; $48.5 billion for public
transit; $66 billion for rail; $55 billion for water
infrastructure; $65 billion for broadband and $73 billion for power
infrastructure. In addition, the group is proposing spending $47.2
billion on climate resiliency, $25 billion for airports, $10
billion on electric buses and $16 billion for ports.” Of the $360
billion for road and bridges, $110 billion would be new
spending.

Pay-fors still a problem: As is always the case with
infrastructure proposals, though, any optimism is clouded by
questions about how to pay for new spending. “We’re making
progress, particularly on key investments that we need to build out
our nation’s infrastructure and prepare for the clean energy
economy that is coming,” National Economic Council Director Brian
Deese
told CNN on Monday. “We still have some sticking
points, particularly around how we pay for this.”

White House Press Secretary Jen Psaki told “CBS This Morning”
that the administration still needs to see “a few more details”
about the plan, “including specifics about how to pay for it.” She
added that Biden would not accept an increase in the gas tax, which
the White House says would violate Biden’s pledge not to raise
taxes on people making less than $400,000 a year. “We’re just not
going to stand for that and we’re not going to accept that,” she
said.

The White House has also opposed proposals to re-purpose unspent
Covid-19 relief funds and a fee on electric vehicles.

Psaki said that Biden would probably be speaking with and
hosting some lawmakers at the White House over the next couple of
days. At the same time, administration officials emphasized that
Biden, while open to continuing discussions about the bipartisan
deal, was also pursuing other paths to an infrastructure
package.

Congressional Democrats are pressing ahead with a broader
package that could be passed by the special budget reconciliation
package, meaning it would not necessarily require Republican votes.
That package may total as much as $6 trillion, including Biden’s
plans for child care, elder care and education, along with a
reduction in the Medicare eligibility age to 60 and an expansion of
the health care program’s benefits to include vision, hearing and
dental services (see more on this below). But getting the necessary
Democratic votes to pass such a package will likely be complicated
as well.

The bottom line: Sen. Lindsey Graham (R-SC)
said Sunday that a $1 trillion infrastructure deal
is “there for the taking,” but the issue of pay-fors could scuttle
any deal. Sen. Shelley Moore Capito (R-WV), who negotiated over a
separate infrastructure deal with Biden, said Monday that Biden
”really wants the bipartisan deal” but suggested that financing any
package will remain a problem. “Pay-fors will be the big issue. As
it was with me,” Capito said, according to Politico. And the
congressional July 4 recess is rapidly approaching, leaving little
time for a compromise to be reached.

Isaac Boltansky, director of policy research at investment bank
Compass Point, isn’t buying the optimism: “The bipartisan effort
will drive headlines in Washington this week,” he said, according
to Politico, “but we remain bearish given the lack of detail,
progressive reticence, and persistent divides over both scale and
scope.”

Quote of the Day

“The bottom line here is that no matter how all this
plays out, and I’m referring to a bipartisan bill versus a
reconciliation process, a whole lot of Democratic priorities are
going to be left on the cutting room floor. The question is how the
left responds.”

– Jim Manley, a strategist and former Senate Democratic
leadership aide, as quoted at
The Hill in a piece looking at tension between
President Biden and the progressive wing of the Democratic Party
over the infrastructure package.

Schumer Says He Backs Broader Medicare Coverage

Senate Majority Leader Chuck Schumer (D-NY) said Sunday that he
supports an effort led by Sen. Bernie Sanders (I-VT) to expand
Medicare coverage to include a more robust set of services.

“There is a gaping hole in Medicare that leaves out dental,
vision, and hearing coverage. This is a serious problem,” Schumer

tweeted. “I’m working with @SenSanders to push to
include dental, vision, and hearing Medicare coverage in the
American Jobs and Families Plans.”

A handful of Democratic lawmakers are trying to include an
expansion of Medicare coverage in the still-developing
infrastructure bill. Schumer told the New York Daily News that
doing so will be an “uphill legislative effort.”

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