During the federal shutdown, the Centers for Medicare and Medicaid Services is responding to the states about critical issues related to implementation of the Affordable Care Act (ACA). But if it’s not about the ACA, states are on their own.The National Association of Medicaid Directors reports nearly complete radio silence on CMS processing of non-ACA waivers and state plan amendments pertaining to the running of state Medicaid programs. States are constantly asking CMS for advice or permission regarding changes to their Medicaid program, whether it be a new proposal for delivering health care in long-term nursing to altering provider reimbursement rates.
But there’s no one at CMS to take those requests now. On issues unrelated to either Medicaid expansion or health insurance exchanges, said NAMD executive director Matt Salo, “There’s no one to answer now, so [states] are left wondering, ‘What do we do now? Do we move forward and implement these changes only to possibly have to undo them later?’”
No surprise, CMS has determined that personnel related to implementation of the exchanges and Medicaid expansion, both of which will start providing coverage on Jan. 1, are essential. All others, including those in CMS’ 10 regional offices, have been furloughed.
“Everything not related to the ACA has essentially been put on hold,” Salo said.