Lawmakers are trying to find a way to hold down costs but also treat states fairly. News outlets also report on efforts to change Medicaid operations in Wisconsin, Indiana, Kansas, Oregon and Nebraska.

Modern Healthcare:
Capping Medicaid Spending May Prove Harder Than It Sounds For Senate Republicans 

Behind closed doors, Senate Republicans are struggling to agree on how to restructure Medicaid as part of their quest to repeal and replace Obamacare. One of the biggest points of contention for the sequestered senators is whether and how to convert open-ended federal funding for all Medicaid beneficiaries into a system of capped payments to the states that would cut the growth of those contributions.
That change would affect all of the nearly 70 million Americans—including children, pregnant women, and elderly and disabled people—who now receive benefits through the $552 billion program, for which the federal government picks up about 57% of the cost. (Meyer, 4/24)

The Associated Press:
Wisconsin Seeks To Be First To Drug Test Medicaid Applicants

Gov. Scott Walker wants to make Wisconsin the first state in the country to require childless adults applying for Medicaid to undergo drug screening, a move that could serve as a national model. Walker’s plan, which needs federal approval, comes as he prepares to run for a third term next year. Wisconsin’s Republican-controlled Legislature approved Walker’s request for a waiver to do the drug tests two years ago, but is now digging into the details of how it would actually work. (Bauer, 5/25)

Indianapolis Star:
Gov. Eric Holcomb Wants Some Medicaid Recipients To Work

Gov. Eric Holcomb is seeking permission from the federal government to require some Medicaid recipients to work or do work-related activities. Indiana’s governor announced Wednesday he’s amending the state’s January application for its alternative Medicaid program to ask for that — and other changes — as the federal government decides whether to keep the Healthy Indiana Plan going past this year. (Groppe, 5/24)

Federal Officials OK ‘Corrective Plan’ As Kansas Pursues KanCare Extension 

Federal officials this week approved a corrective plan for Kansas’ privately managed Medicaid program, easing pressure on the state before a year-end deadline. As part of the plan, state officials agreed to keep track of the number of grievances and appeals they receive from Kansans in Medicaid who say they were denied appropriate services. That and other elements of the plan were outlined in a letter the state received Monday from James Scott, associate regional administrator for Medicaid and children’s health operations at the Center for Medicare and Medicaid Services. (Wingerter, 5/24)

East Oregonian:
Oregon Had No Plan For Checking Medicaid Eligibility 

When Oregon expanded access to Medicaid in 2014, it had no system in place to perform the annual checks on recipient eligibility required by federal law. That was one of the many flaws of Cover Oregon, a state health care exchange also intended to handle patient registration for Medicaid. Medicaid is the federal government’s health care coverage for the poor and other qualifying groups. In Oregon, about a quarter of the state’s population — approximately 1 million people — receives it. More than three years after the expansion was launched under the Affordable Care Act, the state is scrambling to finish verifying whether every Oregonian on Medicaid — the Oregon Health Plan — meets the criteria. (Withycombe, 5/24)

The Oregonian:
Audit: Oregon’s Medicaid Computer Systems Work Well, But Human Errors Remain 

Oregon’s two computer systems that determine Medicaid eligibility and send payments to health care providers are functioning correctly, according to an audit released by the Secretary of State’s office on Wednesday morning. But human error, through employee overrides of the computer systems and manual data entry, could result in people inappropriately being issued or denied coverage, the auditors wrote. Oregon’s Medicaid program costs $9.3 billion annually, with the state paying $1.2 billion and the federal government covering the remainder. The program, known as the Oregon Health Plan, provides health coverage to more than 1 million low-income Oregonians. (Borrud, 5/24)

Omaha World-Herald:
U.S. Government OKs Nebraska’s Medicaid Waivers For Developmental Disabilities Services

Nebraska has gotten good news from the federal government about services for people with developmental disabilities. Courtney Miller, director of the state developmental disabilities division, said Wednesday that federal officials approved both of the state’s Medicaid waiver applications. The approvals mean that federal Medicaid dollars will continue flowing to Nebraska to help pay for community-based services for developmentally disabled people. (Stoddard, 5/25)

This is part of the KHN Morning Briefing, a summary of health policy coverage from major news organizations. Sign up for an email subscription.