Hearing that one of last open issues in negotiations is poison pill provision inserted into latest draft of stimulus bill that could cause hundreds of thousands of people to lose Medicaid during the public health crisis, even as states receive additional federal Medicaid funds /1
Background: The Families First Act passed last week had a temporary federal matching funds rate increase for Medicaid (called FMAP). /2
As w/ Recovery Act, Fam First Act included "maintenance of effort" (MOE) requiremts for states to prevent them from taking federal $ & then cutting Medicaid programs (i.e., no diverting federal $ intended to help them keep Medicaid intact to other parts of state budget) /3
Families First Act had strong "maintenance of effort" language, saying that while there's Public Health Emergency, states can't kick people off Medicaid if they were enrolled prior to the emergency or enroll before it ends. /4
E.g. states do periodic income checks to confirm folks still Medicaid-eligible. But b/c data are lagged, cld overstate current income. During crisis, don't want states terminating coverage based on old data or requiring extra red tape that cld cause people to lose coverage /5
There are also certain populations that would roll off of Medicaid under normal circumstances - e.g. new moms who'd usually lose coverage after initial post-partum period, minors at age 19, etc. Fam First Act says those people wouldn't lose Medicaid for duration of emergency /6
Anyway, new poison pill provision of this "phase 3" bill – not included in earlier bill drafts – guts this "maintenance of effort" requirement, and would effectively allow states to terminate people's Medicaid coverage during public health emergency. /7
In this bill draft, I'm told, governors could basically check a box anytime in next 30 days if they want to keep terminating coverage for people during public health emergency. And given past behavior, reasonable to worry that Trump admin CMS would push states to check the box /8
This is the language I received, which would amend the strict MOE requirements from the Family First Act and allow states to terminate people's Medicaid coverage even as states receive more federal Medicaid dollars. /9 
update!
