Cost Sharing and Premiums Archive

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  • Young v. Azar, D.D.C.

    Four low-income individuals from Michigan enrolled in Medicaid filed a class action lawsuit against the Trump administration challenging its approval of Michigan’s Medicaid waiver project, which includes an illegal work requirement and allows Michigan to charge enrollees premiums and terminate coverage for failure to complete certain “healthy behaviors.” Partners: Center…

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  • Rose v. Azar, D.D.C.

    Litigation Team ,

    Indiana residents enrolled in Medicaid filed a lawsuit against the Trump administration challenging its extension of a Section 1115 project (HIP 2.0) allowing the State to condition Medicaid eligibility on compliance with work requirements. The approval also permits Indiana to charge enrollees premiums; terminate coverage and prohibit re-enrollment in…

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  • National Health Law Program Comments on HHS Safe Harbor Rule for Outpatient Prescription Drugs

    The U.S. Department of Health and Human Services (HHS) proposed new regulations that would remove safe harbor protections for prescription drug rebates. Currently, rebates paid by manufacturers to Medicare Part D plans and Medicaid managed care organizations (MCOs), including pharmacy benefit managers (PBMs) are shielded from federal anti-kickback laws.…

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  • Medicaid Coverage of Inpatient Psychiatric Treatment for Individuals Under 21

    In this fact sheet, National Health Law Program attorneys Héctor Hernández-Delgado and Kim Lewis explain how state Medicaid agencies can ensure quality mental health care is accessible to low-income individuals 21 and younger. The authors also recommend state Medicaid agencies provide home-and-community based care for youth with long-term psychiatric care needs. "Long term…

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  • Stewart v. Azar, D.D.C. and D.C. Circuit

    Litigation Team and

    Sixteen Kentuckians enrolled in Medicaid filed a class action lawsuit against the Trump administration challenging its approval of a section 1115 waiver, which would allow sweeping changes to Kentucky’s Medicaid program, including work requirements, premiums, lockouts, and other changes, that will terminate Medicaid coverage of tens of thousands of…

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  • Newton-Nations v. Betlach & Sebelius, District of Arizona and Ninth Circuit Court of Appeals

    Litigation Team and

    Medicaid beneficiaries in Arizona challenged Arizona’s decision to impose expensive copayments that exceeded the limits set out in federal law, creating barriers to beneficiaries’ access to services. Plaintiffs also challenged the United States Department of Health and Human Services approval of those copayments through the federal Section 1115 authority.…

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