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Virginia GAP and ARTS Delivery System Transformation - Extension Request

Jan 7th 2019 2:10 pm Response: #396973 I am writing to you today regarding Virginia’s Medicaid waiver proposal, I oppose the aspects of this program that create new burdens on people who are already struggling. Monthly premiums of any amount would be too expensive for many families to pay regularly. These are already very poor families who struggle to afford basics like food and rent. If they qualify for Medicaid, they are unlikely to have the extra money to pay a premium. I am pleased to offer these comments and hope you will consider them.
Jan 7th 2019 2:06 pm Response: #396969 I am opposed to certain new burdens included in the proposed 1115 waiver application. Medicaid should help people when they are going through tough times. Health care is a human right and should not be taken away for failure to comply with this type of red tape and bureaucracy.
Virginians should not be penalized if their health condition prevents them from working, particularly in a manner that takes away health coverage and access to treatments and services. This proposed work requirement punishes people with poor health. Thank you very much for considering my thoughts on this waiver application.
Jan 7th 2019 5:30 am Response: #396957 The comments below, describe my concerns about and opposition to the proposed changes to Virginia’s Medicaid program. Losing coverage could create a life-threatening obstacle to care for patients with heart disease as these individuals are unlikely to have access to the necessary treatments and medications. Thank you very much for considering my thoughts on this waiver application.
Jan 6th 2019 10:35 pm Response: #396949 I am writing as a public health researcher and concerned citizen to speak up against the Virginia GAP and ARTS extension request.

Ample evidence already exists that waivers such as these lead to reduced access to medical care for poor Americans --including the working poor. What's more, they do so without accomplishing their stated goal of promoting work; in fact, because the barriers to enrollment imposed by such policies reduce healthcare access, they make it more difficult for beneficiaries to stay well enough to retain their jobs. As far as monthly premiums are concerned, there is extensive research evidence that interventions aimed at ensuring that beneficiaries "have more skin in the game" do not lead to better utilization of healthcare resources.

We already know what to expect if this waiver is approved: People who need Medicaid the most will be dropped from the rolls. This flies in the face of the statutory goals of the Medicaid program. Many will be harmed because they will be unable to receive needed care, or because they need to care for family members who are unable to receive needed care. And safety net healthcare organizations --already operating on razor-thin margins-- will be forced to provide more uncompensated care. There will be no counterbalancing benefits.
Jan 6th 2019 10:02 pm Response: #396945 Attached are comments of the Bazelon Center for Mental Health Law
Jan 6th 2019 9:52 pm Response: #396941 I oppose the new requirements to the Medicaid waiver proposed by DMAS. They have proven ineffective in other states where they have been tried, and do not make sense. A majority of Medicaid recipients already work or cannot work due to caregiver duties, disabilities, etc. Work requirements will thus cost money with no added benefit, and deny coverage to Virginians the health care they need.
Not only is it unethical, but taking away people's health care does not make sense. Research shows that access to health care benefits both individuals and society as a whole. Please do not ignore evidence that proves these new work requirements do not make sense, and will cost both money and lives.
Jan 6th 2019 8:00 pm Response: #396933 This is regarding my concerns surrounding the waiver draft for the Medicaid program in Virginia. Research shows that health and wellness accounts like the one proposed in the Virginia COMPASS application have bad implications. Similar accounts that require enrollees to contribute premiums may cause those people to cut back on needed health services. This will cost the enrollee and the state more money in the future.
Many Virginians depend on Medicaid when they are sick and need help. Implementing this proposed waiver would mean taking away health care when people are most vulnerable. If someone has low income and becomes ill and cannot work that is not the time to take away their coverage. I am hopeful that you change the proposed waiver.
Jan 6th 2019 7:32 pm Response: #396929 Please see attached comments from This is Medicaid.
Jan 6th 2019 6:53 pm Response: #396925 Please see Justice in Aging’s comments and supporting documentation attached.
Jan 6th 2019 5:46 pm Response: #396917 Most Medicaid recipients are already exempt from the work requirements listed in IV.A and spending an estimated $34 million in an attempt to police and place additional barriers on low-income households receiving benefits is wasteful. We have already seen Arkansas attempt such a demonstration, which has not resulted in any successes. To monitor and implement processes for this and section IV.C would come at a much greater monetary cost than they are worth.
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