George Washington University.
J Health Polit Policy Law. 2021 Aug 1;46(4):611-625. doi: 10.1215/03616878-8970824.
Medicaid presents both legislative and regulatory challenges and opportunities. As it moves a legislative agenda forward, the Biden administration also will confront a series of immediate regulatory matters, some of which have been made urgent because of pending judicial action. Chief among these pressing matters are ending Medicaid work requirements and block grant experiments, rescinding the public charge rule, ensuring optimal use of Medicaid's enrollment and renewal simplification tools, rescinding the Title X family planning rule (which has enormous implications for Medicaid beneficiaries), and, when the time comes, preparing states to wind down the "Families First" Medicaid maintenance of effort protection while avoiding erroneous beneficiary disenrollment. The administration could consider encouraging remaining nonexpansion states to pursue §1115 Medicaid expansion experiments; additionally, the administration could pursue Medicaid pandemic recovery demonstrations to support health system recovery during the long period that lies ahead. Thus, while certain advances must await legislation, the administration can move Medicaid forward through executive action.
医疗补助计划既带来了立法和监管方面的挑战,也带来了机遇。拜登政府在推进立法议程的同时,还将面临一系列紧迫的监管事项,其中一些事项因待决的司法行动而变得紧迫。这些紧迫事项中最重要的是终止医疗补助计划的工作要求和拨款实验,撤销公共负担规则,确保最佳利用医疗补助计划的登记和更新简化工具,撤销计划生育法规(对医疗补助计划的受益人有重大影响),以及在适当的时候,让各州做好准备,在“家庭第一”医疗补助计划的维持努力保护下,避免错误地取消受益人的参保资格。政府可以考虑鼓励其余的非扩张州追求第 1115 条医疗补助扩张实验;此外,政府可以进行医疗补助疫情恢复示范,以支持未来漫长时期的医疗体系恢复。因此,虽然某些进展必须等待立法,但政府可以通过行政行动推动医疗补助计划向前发展。