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Medicaid Work Requirements: Policy Considerations & More

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Medicaid work requirements are one of the top Medicaid policies currently being considered for inclusion in Budget Reconciliation. This document includes ten ideas to consider when drafting / agreeing to policy language so as to maximize the chance of the policy leading to meaningful employment and/or educational engagement, and minimize the negative impact on coverage loss and health. It also includes five ideas for key things to keep an eye on in terms of poison language that could be slipped into the bill. Examples of work requirements from three states are highlighted and compared: Georgia’s Pathways to Coverage program, Arkansas’ ArkansasWorks (ARWorks), and Alabama’s approach. To better understand the GOP’s perspective, summaries of work requirement language from Project 2025, the Heritage Foundation, the House Budget Committee’s list of potential policies for Budget Reconciliation, and the draft Limit, Save, Grow Act (H.R. 2811) are also outlined.

The full document is available here:

Impact Health Policy Partners__Medicaid Work Requirements__Key Things to Consider and More__3.21.25_PDF

House Budget Committee Republicans Launch Healthcare Task Force

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House Budget Committee Republicans Launch Healthcare Task Force

On Friday, August 25, House Budget Committee Chairman Jodey Arrington (R-TX) and Budget Committee Member Rep. Michael C. Burgess, M.D. (R-TX) announced the formation of a new Budget Committee Health Care Task Force, which will be led by Rep. Burgess.

Motivated by the recent U.S. credit downgrade and the increasing burden of healthcare costs, the goal of this Task Force is to find solutions to reduce healthcare spending, examine opportunities to modernize and personalize the healthcare system, and support policies to fuel innovation and increase patient access to quality and affordable care.

The Task Force issued a request for information (RFI) to solicit feedback from stakeholders on solutions to improve outcomes and reduce federal healthcare spending in the budget. Responses are due by October 15, 2023.

It is important to note that this Task Force is comprised of only Republican members, thereby limiting the chance of meaningful legislative reforms.

In an opinion piece published by The Hill, Chairman Arrington and Rep. Burgess quoted a Kaiser Family Foundation report that stated nearly one-third of federal government spending this year will be on health care, which is projected to grow from $1.9 trillion to over $3.4 trillion by 2033.  Furthermore, with the growth of baby boomers retiring, annual Medicare spending alone has already surpassed spending on national defense, and by 2033, is projected to more than double to $1.7 trillion.  The Task Force will seek input from independent experts and stakeholders on how to build on what is working in healthcare and fix what is broken.

The Task Force will further “serve as a forum for developing and modeling legislation to improve spending efficiency, returns on federal investments, and an overall more cost-effective health care system.” This could include payment model reforms that reward value-based care and reimbursement based on improving quality and clinical outcomes in place of traditional fee-for-service payments.

Finally, the Task Force will examine the Congressional Budget Office’s (CBO) capabilities to forecast the longer-term budgetary impacts of legislation to ensure policymakers are equipped with the best data when crafting solutions.

We hope you find this information helpful, and please let us know if you have any questions.

Impact Health Contacts for Inquiries

Alyson Lewis: alyson@impacthealthpolicy.com; (202) 441-5671

National Advisory Council Explores How Research Can Contribute To Firearm Injury Prevention; Hears from CDC and NIH Regarding Current and Future Initiatives

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Firearm injury prevention is a strategic imperative of the National Advisory Council for Nursing Research (NACNR). Earlier this month, the Council held a meeting focused on the role nurse scientists and nursing research can play in firearm injury prevention. 

 

Presentations outlined the National Institutes of Health (NIH) and Centers for Disease Control and Prevention (CDC)’s current firearm injury prevention research initiatives including the identification of gaps in current research and opportunities for future collaboration.  Research by the National Institute of Nursing Research (NINR) was presented and focused on reducing firearm injury and related health impacts by developing, evaluating and translating preventive interventions into routine practice in community health settings.  The broader intention of NINR’s research is to normalizing prevention screenings and the role community health care settings can please in helping stop firearm violence.

 

Highlights from the meeting are outlined below:

  • Overview of NIH Research Support on Firearm Prevention – Dr. Christine Hunter, Acting Director of NIH’s Office of Behavioral and Social Sciences Research (OBSSR), provided an overview of NIH research on firearm injury and mortality prevention. Dr. Hunter noted the following in the presentation:

 

    • Firearm violence is an urgent public health crisis, with firearm homicide rates increasing by 35% from 2019 to 2020;
    • Large disparities exist by race, ethnicity, and poverty; significantly impacting African American and American Indian and Alaska Native (AIAN) populations;
    • Fiscal Year 2020-2023 appropriations report language provided $12.5 million to NIH and CDC to conduct research on firearm injury and mortality prevention, particularly around studying underlying causes and evidence-based methods or prevention of injury;
    • NIH firearm research funded by federal appropriations took a broad public health approach, examining different types of violence and populations, and studying risk and protective factors for firearm injury/mortality at multiple levels; and
    • Future priorities in research include capacity building and training support, particularly for principal investigators (PIs) from traditionally under-represented populations.

 

Dr. Hunter also highlighted an open opportunity for research on community level interventions for firearm and related violence, injury and mortality prevention, found grants/guide/pa-files/PAR-23-066.html”>here. Applications are due March 17, 2023.

 

  • CDC Initiatives – Dr. Thomas Simon, Senior Director for Scientific Programs of the CDC’s National Center for Injury Prevention and Control presented about firearm violence and injury prevention research and activities. Dr. Simon noted that CDC’s research aims to improve understanding of firearm injury and inform the development of interventions.  It also aims to identify effective strategies to keep individuals, families, schools, and communities safe from firearm-related injuries, deaths and crime. Dr. Simon discussed the Firearm Injury Surveillance Through Emergency Rooms (FASTER) initiative which provides surveillance data in near-real time on emergency visits for nonfatal firearm injuries. Additional information on the FASTER initiative can be found here; current firearm research funding opportunities through the CDC can be found here.

 

  • NINR Research Concept – Dr. Sweta Singh, Dr. Karen Huss, and Dr. Karen Kehl presented to the council regarding a research concept in firearm injury prevention in community health care settings. They noted the following:

 

    • Firearm injury is a source of health disparities in the US, with homicides affecting primarily Black communities and those with the highest poverty levels;
    • Firearm injuries and deaths are context dependent, and research to improve prevention in the health care setting should prioritize the most pressing local needs, and involve meaningful and sustained community engagement;
    • NINR’s research purpose is to reduce firearm injury and related health sequelae by developing, evaluating and translating preventive interventions into routine practice in community health settings. The research would study the following topics:
      • Screenings, direct assessments and education interventions that can be customized for use in specific community health care settings;
      • Models of care that leverage nurses’ unique skill, perspectives, and relationships with people and organizations with whom they interact can normalize firearm injury prevention activities in community health care settings; and
      • The way social determinants of health affect efficacy or effectiveness of firearm injury prevention programs, implementation and their sustainability.

 

The National Advisory Council for Nursing Research closed the meeting with an expression of its appreciation for the opportunity to learn from research supported by NIH and CDC, and expressed its hope for additional synergy in future research and collaboration. Council members underscored the need for increased funding for this type of research given that firearm-related injury is the leading cause of death among children.  They noted that firearm injury prevention in community health care settings is a strategic imperative for NACNR’s nursing science research portfolio.

 

We hope this information is helpful. Please reach out with any questions you might have.

 

WHG Contacts for Inquiries

Victor Colocho: victor@wynnehealth.com; (443) 915-6070

Dawn Joyce: dawn@wynnehealth.com; (510) 847-2900

EPA Comment Opportunity + Webinars: New Programs to Lower the Health and Environmental Impact of Construction Materials

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The Inflation Reduction Act (IRA) was passed in August 2022 with the intention of combating the climate crisis.  The Environmental Protection Agency (EPA) received $41.5 billion in appropriations to develop and support 24 new and existing programs that monitor and reduce greenhouse gas emissions and air pollution, protect health and advance environmental justice.

 

The EPA recently announced stakeholder engagement opportunities – including two webinars and a request for information (details below) – to shape new grant and technical assistance programs as well as a carbon labeling program for construction materials.  The new programs are funded by a $350 million in IRA funding and are intended to help manufacturers, institutional buyers, real estate developers, builders and others measure, report and substantially lower the levels of embodied carbon and other greenhouse gas emissions associated with the production, use and disposal of construction materials and products including steel, concrete, asphalt and glass. The work will also support the Buy Clean Task Force which is developing recommendations for Federal procurement and federally funded projects that would expand consideration of greenhouse gas emissions and other pollutants associated with construction materials.

 

Webinar details are as follows:

 

  • March 2, 2023 from 2:00-3:30 p.m. EST
    • Topic:  Reducing Embodied Greenhouse Gas Emissions: Construction Materials Prioritization and Environmental Data Improvement.
    • Registration is required and available here.

 

  • March 22, 2023 from 2:00-3:30 p.m. EST
    • Topic:  Reducing Embodied Greenhouse Gas Emissions: Grants and Technical Assistance for Environmental Product Declarations.
    • Registration is required and available here.

 

Comments are due by May 1, 2023 and can be submitted through https://www.regulations.gov. They must include the docket identification (ID) number EPA-HQ-OPPT-2022-0924.

 

The EPA is seeking input on the following questions and also welcomes general input. The agency asks you to please identify the questions you are responding to when you submit your comments.

 

  • What construction materials/products should EPA prioritize in implementation of these programs?
  • What data accessibility and improvement approaches should EPA consider?
  • What standardization, measurement, verification, and reporting approaches for use in procurement decision-making should EPA consider?
  • What factors should EPA consider for the Environmental Product Declaration Assistance program?
  • What should be considered for setting thresholds for “substantially lower levels” of embodied greenhouse gas emission for qualifying materials/products under a labeling program?
  • What would be the key elements of an effective carbon labeling program?

 

Questions regarding the webinars and RFI can be directed to Alison Kinn Bennett, Senior Advisor, Environmentally Preferable Purchasing Program (7409M), Office of Chemical Safety and Pollution Prevention, Environmental Protection Agency, 1200 Pennsylvania Ave., NW., Washington, DC 20460-0001; telephone number: (202) 564-8859; email address: kinn.alison@epa.gov.

HHS Awards $245 Million in Bipartisan Safer Communities Act Funding to Support Youth Mental Health and Help Primary Care Providers Meet Families’ Mental Health Care Needs

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The Department of Health and Human Services (HHS) announced almost $245 million in Bipartisan Safer Communities Act funding awards to support youth mental health.  This includes $185.7 million from the Substance Abuse and Mental Health Services Administration (SAMHSA) for a range of investments (outlined below) and almost $60 million from the Health Resources and Services Administration (HRSA) to help primary care providers better meet the mental health needs of the families they serve by integrating mental health training into training for primary care clinicians.

 

SAMHSA’s Bipartisan Safer Communities Act awards include:

 

  • grants-dashboard?grants_dashboard__search=%22Project%20AWARE%20(Advancing%20Wellness%20and%20Resiliency%20in%20Education)%22&f%5B0%5D=by_award_fy%3A2023&f%5B1%5D=by_nofo_fy%3A2022&f%5B2%5D=by_nofo_number%3ASM-22-018#awards-tab”>$73.6 million for Project Advancing Wellness and Resiliency in Education (Project AWARE) to help develop and support school-based mental health programs and services;
  • $57.7 million in Mental Health Awareness Training grants to prepare and train school personnel, emergency first responders, law enforcement and others to recognize the signs and symptoms of mental health challenges to enable early intervention;
  • $14.9 million for School Based Trauma-Informed Support Services and Mental Health Care for Children and Youth to increase student access to evidence-based and culturally relevant trauma support services and mental health care;
  • $19.5 million for the National Child Traumatic Stress Initiative, to improve treatment and services for children, adolescents, and families who have experienced traumatic events; and,
  • $20 million in Resiliency in Communities after Stress and Trauma grants to promote resilience and equity and prevent violence in communities that have recently faced civil unrest, community violence, and/or collective trauma.

 

HRSA’s Bipartisan Safer Communities Act awards include:

  • Nearly $60 million to support the integration of mental health training into the training of primary care clinicians, with a specific focus on preparing primary care providers to treat the mental health needs of children and adolescents.

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