Listening to Nicole Huberfeld at ASLME so eloquently place Medicaid's latest vicissitudes in historical context was a tonic. Yes, Medicaid's precursor, the Kerr-Mills Act, has some resonance with Medicaid as it might look after the passage of the AHCA combined with some of the pending Section 1115 waivers requested by the states. Think of every eligibility requirement and condition borrowed from TANF and you will have some sense of the scope of what some states would like to attach as conditions to Medicaid enrollment. All of these new eligibility screens merit discussion as to whether they fulfill the purpose of the Medicaid Act itself and work to promote access to Medicaid treatment. Congress may, in fact, change the purposes of the Medicaid Act as it sees fit, however. The House version of the AHCA does, indeed, propose to add a work requirement to the statutory purposes of the Medicaid Act.
But what really caught my attention from Nicole Huberfeld's laundry list was Wisconsin's proposal to require drug testing as a condition for Medicaid eligibility. For a moment I paused: positive test to prioritize Medicaid eligibility or positive test to exclude Medicaid eligibility? The latter of course, though with our nationwide drug induced death epidemic, I hope you will excuse my moment of hopeful confusion.