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  • Medicaid Changes Require Tens of Millions in Upfront Costs Roll Call by Misty Williams — The addition of work requirements and other sweeping changes to Kentucky's Medicaid program could cost nearly $187 million in the first six months alone to get up and running. Republican Gov. Matt Bevin projects that the program will eventually yield savings, but the changes require an upfront investment in administrative expenses. Much of that money is aimed at creating complex electronic systems and other changes needed to track work hours, monthly premium payments and other elements of Kentucky's recently approved plan to revamp the government insurance program for low-income Americans. The vast majority of those dollars — more than $167 million — would be covered by the federal government, according to Bevin's revised budget for fiscal 2018. The budget increase offers a glimpse into the initial costs to launch the Medicaid changes numerous states are seeking.

  • As Trump Pushes Medicaid Testing, the Grading Falls Short New York Times by Robert Pear — The Trump administration is hoping to transform Medicaid by allowing states to test work requirements, premiums, and other conservative policies, but a new government report says federal and state officials do not properly evaluate whether such experiments improve patient care or reduce costs. Evaluations “generally lacked rigor,” and the findings were often kept secret for years, so they were of little use to policymakers, the Government Accountability Office, a nonpartisan investigative arm of Congress, said in the report issued last month. In granting Medicaid waivers, federal officials typically require states to measure the effects of a policy change on costs and the health of beneficiaries. But, the report said, it is often difficult to isolate those consequences because the overall health care system is changing so fast.

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