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Questionnaire NameVirginia GAP and ARTS Delivery System Transformation - Extension Request
DescriptionVirginia requests an extension to the 1115 demonstration Virginia GAP ARTS Delivery System Transformation, renamed, Virginia COMPASS: Creating Opportunities for Medicaid Participants to Achieve Self-Sufficiency. The application requests to extend the current demonstration as well as implement a community engagement program for eligible adult populations. Beneficiaries will initially be required to work 20 hours per month, increasing to 80 hours per month after one year. Failure to comply with the requirements will result in suspension of Medicaid benefits. The state proposes including a number of exemptions and exceptions. The state will also require eligible beneficiaries with incomes 100 to 138 percent of the federal poverty level to pay monthly premiums. The premium amount will be based on a sliding income scale. Beneficiaries will make monthly premium payments of $5 to $10. The federal comment period will be open from December 7, 2018 through January 6, 2019.
Response FromID: #396949 on Jan 6th 2019 10:35 pm
Virginia GAP and ARTS Delivery System Transformation - Extension Request

Virginia GAP and ARTS Delivery System Transformation - Extension Request

We encourage the public to submit their comments on Medicaid.gov as they relate to demonstrations open for public comments. In support of transparency and open government, all public comments received are immediately posted and are in the public domain. Center for Medicaid and CHIP Services staff will review all public comments posted and we reserve the discretion to delete comments that are generally understood as any of the following: obscene, profane, threatening, or otherwise inappropriate.

Refer to the Application

Open for Public Comment – 12/7/18 – 1/6/19

Please provide your comments here and/or attach below:

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.
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