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Some states tie Medicaid expansion to 'personal responsibility.' Could it catch on?

Kaiser Health News story

This spring, Michigan became the second state after Iowa to offer lower healthcare premiums and cost sharing to recipients who agree to do a health risk assessment with their doctor every year and to commit to improve their health by taking steps such as quitting smoking or losing weight.

The hope is that giving people a financial incentive to change their behaviors will improve their health and control Medicaid spending. 

Other states, such as Pennsylvania, are also seeking to tie Medicaid coverage to personal responsibility by seeking federal approval for a plan that would prod unemployed people to search for jobs and get annual wellness exams in exchange for lower premiums.  Carrot-stick-mans-head

In an effort to give Medicaid recipients more “skin in the game,” as proponents call it, most newly eligible Michigan recipients will face copays — typically from $1 to $3 for most outpatient health services. Those with incomes between 100 percent ($11,670) and 138 percent ($16,105) of the federal poverty level will also pay a premium of 2 percent of their income.

While many states impose similar cost-sharing, Michigan will be the first to ask enrollees to make those payments -- either co-pays or premiums or both -- through a health savings account. Read more. 

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