THIS PROGRAM IS MADE BY MPT TO ENRICH THE DIVERSE COMMUNITIES THROUGHOUT OUR STATE AND IS MADE POSSIBLE BY THE GENEROUS SUPPORT OF OUR MEMBERS.

THANK YOU.

[♪♪] CONNECTING MARYLANDERS TO THEIR GOVERNMENT, THIS IS "STATE CIRCLE".

>> Jeff: WELCOME TO "STATE CIRCLE".

JUST AHEAD ON OUR PROGRAM THIS WEEK THE STALL SHIPS THEY ARE RIDING HIGH IN BALTIMORE'S HARBOR AND NEW REQUIREMENTS FOR MEDICAID PARTICIPANTS.

BUT FIRST THIS WEEK THE ELECTION RESULTS IN THE RACE FOR GOVERNOR IT WILL BE DEJA VU WITH DEMOCRAT WES MOORE FACING REPUBLICAN PRIMARY WINNER DAN COX.

WE'LL DISCUSS WHETHER THAT RACE MIGHT BE CLOSER THAN IT WAS FOUR CAREERS AGO IN OUR ROUNDS TABLE COMING UP.

IN OTHER TOP RACES DEMOCRATS NOMINATED A FORMER AIDE TO FIFTH DISTRICT CONGRESSMAN STENY HOYER TO BE HIS SUCCESSOR.

HE WILL FACE CHRIS CHAFEE IN THAT DEMOCRATIC DISTRICT.

IN THE DEMOCRATIC LEANING SIXTH DISTRICT, APRIL MCCLAIN DELANEY TURNED BACK A CHALLENGE FROM FORMER REPRESENTATIVE DAVID TRONE WHO INVESTED 25 MILLION OF HIS FUNDS IN THE CHALLENGE.

ROBIN FIXER LEADS THE REPUBLICAN FIELD.

AND BILL FERGUSON FOUGHT BACK A SERIOUS CHALLENGE TO HIS 46TH DISTRICT SENATE SEAT ON THE WAY TO A FIFTH TERM REPRESENTING THAT BALTIMORE CITY DISTRICT.

[♪♪] FOR THE POLITICAL ROUNDS TABLE WE ARE JOINED BY ROGER HARTLEY FORMER DEAN PROFESSOR AT THE UNIVERSITY OF UNIVERSITY OF BALTIMORE'S COLLEGE OF PUBLIC AFFAIRS AND MALCOLM DREWERY THANK YOU FOR YOUR TIME WE ARE GOING TO THE MOVIES AND SEE A SEQUEL IS WES MOORE VERSUS DAN COX PART TWO.

THE ORIGINAL WASN'T PARTICULARLY COMPELLING IT WAS A LANDSLIDE FOR GOVERNOR MOORE.

ROJ ARE IS THERE ANYWAY IT'S SGNIFICANTLY CLOSER THIS TIME?

>> I REALLY DON'T THINK SO.

I THINK THIS IS GOING TO BE ANOTHER MOVIE THAT PEOPLE AREN'T GOING TO WANT TO SEE.

ONE OF THE ISSUES FOR DAN COX ALTHOUGH I HEARD ON THE CAMPAIGN TRAIL HE HAD BEEN A LITTLE MORE MODERATE THAN HE WAS LAST TIME.

BUT WES MOORE HAS EVEN WITH LOWER APPROVAL RATINGS THEY ARE HIGH.

IT IS A DEMOCRAT STATE AND DEMOCRATS WILL BE ENERGIZED TO TURNOUT EVEN THOUGH THERE IS NOT A PRESIDENT AT THE TOP OF THE TICKET PEOPLE WANT TO VOTE GIVEN THE THINGS THAT ARE HAPPENING IN WASHINGTON.

I THINK WE ARE LOOKING AT A LANDSLIDE.

>> Jeff: MALCOLM YOU AGREE?

>> I TOTALLY AGREE.

I FOUND IT INTERESTING QUESTION BECAUSE I THOUGHT THAT IF, IF, I'M NOT GOING TO SAY ANYTHING IS JUST GUARANTEED ALL OF THE STARS HAVE TO ALIGN TO MAKE SOMETHING LIKE THAT HAPPEN.

I WOULD NEVER SAY NEVER.

IF YOU KNOW, THE QUESTION WAS WHETHER THE RACE COULD BE COMPETITIVE I WOULD SAY YES, IT COULD BE.

BUT IT WOULD HAVE TO BE SEVERAL DIFFERENT DEVELOPMENTS THAT WOULD HAVE TO OCCUR SIMULTANEOUSLY IN ORDER FOR THAT TO HAPPEN.

WORSE ECONOMIC ISSUES, SOME REAL STRONG ANTI-INCUMBENT MOOD, REDUCED DEMOCRATIC TURNOUT.

SOMETHING LIKE THAT AND THE REPUBLICANS WILL HAVE TO PICK UP ALL THE INDEPENDENTS AND A LOT OF THE DEMOCRATS IN ORDER FOR SOMETHING LIKE THAT TO HAPPEN.

I DO SEE LIKE ROGER SAID A LANDSLIDE.

YOU KNOW, WES MOORE IS THE CLEAR FAVORITE.

>> YOU KNOW, I DIDN'T MEAN TO SOUND SO NEGATIVE BUT THE REAL INTERESTING THING HERE FOR THE REPUBLICAN PARTY RIGHT NOW IS THAT THEY HAD EIGHT YEARS OF LARRY HOGAN THEY HAD A STRONG LEADER IN OFFICE AND IT APPEARS THEY AS A STATE PARTY HAVE NOT BEEN ABLE TO CAPITALIZE ON THAT AND HAVE GONE TOWARDS THE DIRECTION OF THE NATIONAL PARTY WHICH CAN'T HOLD-UP IN MARYLAND.

THE BENCH IS REALLY, REALLY THIN.

AND THE LEADERS THAT ARE IN OFFICE RIGHT NOW, ACTUALLY A LOT OF THEM ENDORSED HAIL AND HE DID NOT WIN.

SO IT WAS REALLY INTERESTING TO SEE THAT IT'S ALMOST LIKE THE EIGHT YEARS OF LARRY HOGAN POOF, WENTZ AWAY FOR THE REPUBLICAN PARTY IN MARYLAND AND THAT IS THE ONLY WAY TEAR GOING TO WIN IS APPEAL TO DEMOCRATS AND INDEPENDENTS.

>> Jeff: BOTH PARTIES HAVE MAJOR DIVISIONS THESE DAYS.

MALCOLM, ON THE REPUBLICAN SIDE, CERTAINLY THERE'S THE MAGA WING AND THE TRADITIONAL MAYBE ROMNEY ROCKEFELLER REPUBLICANS.

EVEN WITH PRESIDENT TRUMP'S POPULARITY WAY, WAY DOWN, AND ON THE DEMOCRATIC SIDE IN THIS CYCLE, ESPECIALLY LOOK AT NEW YORK, THIS WEEK, YOU KNOW WE'VE SEEN SORT OF THE RISE OF THE MAMDANI WING YOU MIGHT CALL THE SOCIALISTS.

>> THAT'S AN INTERESTING TAKE.

AND ACTUALLY LOOKING AT IT I'M NOT GOING TO GO AS FAR AS SAYING MARYLAND IS GOING TO BE A REAL MAMDANI WING, BUT, YOU KNOW WITH THE INCUMBENT GOVERNOR ENDORSING A LOT OF THE PEOPLE WHO WON RACES YOU DO SEE A REAL SPLIT BETWEEN LIKE YOU SAID THE SOCIALIST DEMOCRATS AGGRESSIVE DEMOCRATS AND THE BASELINE, WHICH IS GOING TO REALLY, YOU REALLY GOING TO HAVE TO SEE FUSION THERE IN ORDER TO MAKE SOME SIGNIFICANT CHANGES OR DIFFERENCES TO PULL OUT A LOT OF RACES IN NOVEMBER.

AND ALSO LOOKING AT IT FROM A NATIONAL PERSPECTIVE IT WILL BE INTERESTING TO SEE HOW THE POLITICAL PARTY DEMOCRATIC POLITICAL PARTY WILL BE ABLE TO PULL THEMSELVES TOGETHER.

IN ORDER TO MAKE THINGS MORE YOU KNOW, BENEFICIAL FOR THE PARTY AT THE END.

>> Jeff: LET ME TEE UP FOR YOU THE TWO HOT CONGRESSIONAL RACES.

DAVID TRONE TRYING TO RETAKE HIS SEAT IN THE SIXTH DISTRICT, INCUMBENT APRIL MCCLAIN DELANEY PREVAILED THERE AND THEN IN THE BECAUSE HOYER RETIRING FROM CONGRESS.

THE HEADLINE IN THE "POLITICO" WAS HOYER ALUM, ADRIAN WINS THE MARYLAND HOUSE PRIMARY WITH THE HELP OF CRYPTO, PRO-ISRAEL MONEY.

NEITHER OF THOSE REALLY NAIL PITTERS BUT ANYTHING STAND OUT?

>> YEAH, YOU KNOW HONESTLY THE APRIL MCCLAIN DELANEY AFD TRONE RACE WE PREDICTED TO BE CLOSE.

BUT IT REALLY WASN'T CLOSE AT ALL.

AND A TON OF MONEY WAS SPENT AND A TON OF MONEY BY DAVID TRONE AGAIN.

I THINK IT HURT HIM HE LOST THE SENATE RACE.

AGAINST ANGELA ALSOBROOKS AND DELANEY HAS DONE A GOOD JOB OF CONNECTING TO HER DISTRICT AND SHE HAD AN INCUMBENCY FACTOR AND SOMETIMES IT'S HARD TO RECOVER FROM A LOSS LIKE TRONE DID AND THEN MAKE THAT COMEBACK.

I THINK FOR ADRIAN, HE IS A REALLY AN EXCITING YOUNG PUBLIC SERVANT TO SAY THE LEAST.

HAVING THE ENDORSEMENT OF STENY HOYER AND PARTICULARLY IN A RACE WHERE THERE WERE SO MANY PEOPLE RUNNING AND INTERESTING PEOPLE RUNNING IN THAT RACE.

I THINK IT MADE A HUGE DIFFERENCE THAT HE HAD THAT ENDORSEMENT.

BUT HE RAN A REALLY GREAT CAMPAIGN.

THE CAMPAIGN GOT A LITTLE ROUGH-IN SOME PLACES OVER ISSUES ON ISRAEL THAT ARE DIVISIVE INSIDE OF THE DEMOCRAT PARTY RIGHT NOW.

IN TRUTH, HE WON PRETTY BIG AT LEAST A STRONG PLURALITY THERE IN THE DISTRICT.

>> Jeff: MALCOLM FEEL FREE TO JUMP IN.

I WANTED TO POINT OUT THAT THE CANDIDACY OF ADRIAN IN A DEMOCRATIC FIFTH DISTRICT HE IS GOING TO WINDUP AS THE THIRD BLACK MEMBER OF THE MARYLAND DELEGATION TO THE HOUSE OF REPRESENTATIVES IN CONGRESS, WHICH IS A MILESTONE.

BUT INTERESTINGLY IT HAPPENS AT THE SAME TIME THAT THE SUPREME COURT IS ROLLING BACK PROVISIONS OF THE VOTING RIGHTS ACT SO THE OVERALL BLACK CAUCUS MAYBE SHRINKING.

HOW DO YOU THINK ABOUT THAT?

>> GOING BACK AND LOOKING -- THIS IS INTERESTING TO ME.

YOU HAVE TWO DIFFERENT STORIES BETWEEN THESE CONGRESSIONAL DISICK FROMS.

FIRST WITH THE SIX DISTRICT THE LIMITS OF SELF FUNDING LIKE DAVID TRONE SPENT A LOT OF MONEY SPENDING $25 MILLION THIS TIME.

I BELIEVE HE SPENT $60 MILLION THE LAST TIME.

SOMETHING LIKE THAT.

YOU KNOW, JUST DELEWDS THE SEAT TO DELANEY.

BUT THE LESSON MAYBE EVEN JUST COMING OUT OF MARYLAND THAT YOU CAN'T ALWAYS OVERCOME PARTY NETWORKS, ENDORSEMENTS WITH YOUR MONEY.

AND MAYBE THAT'S ONE OF THE ISSUES A LOT OF THE MARYLAND DEMOCRATS REJECT OR HAVE SHOWN A WILLINGNESS TO REJECT CANDIDATES WITH THE DEEPEST POCKETS.

SO THAT'S MAYBE A LESSON THAT CAN BE LEARNED AS WE MOVE FORWARD TO SOME OF THE CANDIDATES.

BUT SECOND, WITH THE FIFTH DISTRICT, YOU HAVE OPPOSITE STORY.

WITH BALANCE FOR WINNING HE DIDN'T OUT SPEND EVERYBODY BUT HE ASSEMBLY EQUALED THIS COALITION WITH STENY HOYER AND WES MOORE AND ALSOBROOKS AND AS YOU INDICATED LIKE HE DID ALIGN WITH CRYPTO GROUPS, AND THIS PRO-ISRAEL ORGANIZATION, FOR FUNDING WHICH IS CONTROVERSIAL.

BUT THAT NETWORK THAT HE PUT TOGETHER, AND BEING ENDORSED BY HOYER SEEMED LIKE IT MADE A SUBSTANTIAL DIFFERENCE IN THE RACE.

TO YOUR QUESTION ABOUT YES, THIS IS DEFINITELY A HISTORICAL SIGNIFICANT ELECTION.

AND HE WILL PROBABLY GIVEN THE FIFTH DISTRICT HE WILL PROBABLY WIN THE GENERAL ELECTION IN MARYLAND.

SO YOU HAVE THREE BACK DELEGATES.

YOU HAVE GLEN IVY.

AND NOW WITH ADRIAN BEING IN THERE, SO YOU KNOW, MARYLAND IS WHAT ROUGHLY 30% BLACK POPULATION, WHICH IS REALLY NOTICEABLE THAT IS NOTABLE.

ESPECIALLY GIVEN THE ROLE OF PRINCE GEORGE'S COUNTY, AS ONE OF THE NATION'S IMPORTANT CENTERS FOR BLACK POLITICS.

LIKE WE MAYBE SEEING SOMETHING A LITTLE DIFFERENT.

AND ACTUALLY, I'M INTERESTED IN THIS JEFF, BECAUSE I'M LOOKING AT THE TRANSITION.

YOU HAD THE CIVIL RIGHTS GENERATION.

GLEN IVY AND LIKE POST CIVIL RIGHTS INSTITUTIONAL GENERATION AND ADRIAN IS THIS YOUNG LEADER AS YOU INDICATED.

YOU KNOW, AFTER OBAMA OPERATING FROM A DIFFERENT POLITICAL ENVIRONMENT THIS IS REALLY INTERESTING.

>> Jeff: ON ADRIAN THERE WAS A GENERATIONAL CHALLENGE THERE THAT HE SURVIVED.

ROGER WERE THERE OTHER RACES YOU FOUND INTERESTING?

>> WELL, I WANT TO ADD TO WHAT YOU SAID INCREDIBLY WELL, MALCOLM WHAT WE'VE BEEN SEEING OVER THE LAST 10 YEARS IS A CHOICE OF MARYLAND FOR DIVERSITY IN ITS ELECTED LEADERS AND THAT CONTINUED.

AND THAT CONTINUED AT THE LOCAL LEVEL.

IT LOOKS LIKE JULIAN JONES IN BALTIMORE COUNTY AN IMPORTANT COUNTY IN OUR STATE IS GOING TO END UP WINNING THE EXECUTIVE RACE A POWERFUL POSITION AND SOMETIMES COUNTY EXECUTIVES BECOME GOVERNORS AND OTHER THINGS NOT TO PUT THAT IN HIS PRESSURE ON HIM SO QUICKLY.

>> Jeff: NO PRESSURE AT ALL.

>> BUT REALLY AND BALTIMORE CITY ELECTED ITS FIRST BLACK WOMAN SHERIFF.

SO MUCH CHOICE THERE.

AND I THINK YOU MADE AN INCREDIBLE POINT ABOUT THE ENDORSEMENTS.

MALCOLM, YOU KNOW IN AN ELECTION LIKE THIS ONE, WHERE TURNOUT WAS LOW THERE WAS A LOT OF CONFUSION SO MANY CANDIDATES AND EVEN IN THE TRONE DELANEY RACE THERE WAS SO MUCH MONEY AND A LOT OF NEGATIVE ADS I THINK WHAT SOMETIMES HAPPENS PEOPLE LOOK AT THE ENDORSEMENTS AS WHEN THEY ARE CONFUSED TO SAY WHO IS GOVERNOR MOORE ENDORSING HERE?

IF YOU REMEMBER THAT IN THE ALSOBROOKS RACE THAT INCREDIBLE AD AT THE VERY END WHERE EVERY STATE ELECTED LEADER WAS STANDING RIGHT BEHIND HER AND IT WAS IN THE LAST WEEK OF THE ELECTION AND I THINK IT MADE A HUGE DIFFERENCE.

YOU WERE RIGHT ON ABOUT EVERY BIT OF THAT.

>> Jeff: GENTLEMEN WE HAVE TO LEAVE IT THERE, PROFESSORS WE APPRECIATE YOUR TIME.

THANK YOU SO MUCH.

>> THANK YOU.

APPRECIATE IT.

>> THANK YOU.

>> Jeff: NOW THERE IS NOTHING MORE FESTIVE THAN THE TALL SHIPS LINED IN BALTIMORE'S INNER HARBOR PART OF THE CELEBRATION OF AMERICA'S 250TH BIRTHDAY WHICH KICKED OFF WITH A CEREMONY THIS MORNING.

[♪♪] [APPLAUSE] >> WE LOOK AT THIS HARBOR AND SEE THE NAVAL VESSELS THAT ARE FLYING THE FLAGS OF NATION'S THAT ARE PARTNERS AND FRIENDS.

WE LOOK AT THE SAILORS WHO CROSSED THE OCEANS TO GET HERE AND THE SKIES THAT WILL BE FILLED FOR THE AIRSHOW AND A QUESTION WORTH ASKING IS HOW WE GOT HERE AND WHAT IT TOOK TO GET HERE.

IT'S WHAT MAKES US STRONG.

YOU CAN SEE IN THE WATER RIGHT NOW YOU CAN HEAR IT IN THE ENGINES.

A NATION THAT IS BUILT THE MOST CAPABLE SHIPS AND AIRCRAFT THAT THE WORLD HAS EVER SEEN.

AND A LOT OF THEM WERE BUILT BY MARYLANDERS.

DRIVEN BY MARYLANDERS.

FLOWN BY MARYLANDERS.

BUT THE STRENGTH OF THIS NATION HAS NEVER JUST BEEN ABOUT WHAT WE BUILT BUT IT'S ABOUT WHO BUILT THEM.

AND THE SACRIFICE THAT THEY WERE WILLING TO MAKE ON BEHALF OF THEIR FAMILIES FOR A HOPE OF US.

BECAUSE AMERICA IS A NATION OF STRENGTH BECAUSE AMERICA IS A NATION OF SACRIFICE.

IT IS A SACRIFICE OF THE SAILOR, WHO LEAVES THEIR HOME.

AND IS WILLING TO LEAVE THEIR FAMILY.

TO DEPLOY FOR MONTHS ON THE POSSIBILITY THAT THEY MIGHT NOT RETURN.

♪WHOSE BROAD STRIPES AND BRIGHT STARS THROUGH THE PAIR PER LOUSE FIGHT.

>> Jeff: SHIPS WILL BE OPEN THIS WEEKEND AND MAJOR AIRSHOWS CENTERED OVER THE RIVER FEATURING THE BLUE ANGELS AND OTHER AIRCRAFT MORE INFORMATION AT SAIL250 MD.ORG.

[♪♪] NOW OUR NEWSMAKER IS MORGAN HENDERSON, SENIOR DIRECT ARE TO HAVE ANALYTICS AND RESEARCH AT THE HILLTOP INSTITUTE AT UMBC.

THANK YOU FOR YOUR TIME.

BIG CHANGES COMING TO MEDICAID.

AND WE'LL TALK ABOUT THAT LET'S EXPLAIN FIRST WHY MEDICAID IS SO IMPORTANT NEARLY ONE IN FOUR MARYLANDERS IS A PARTICIPANT IN MEDICAID.

>> YEAH, JEFF THAT'S RIGHT.

MEDICAID IS AN ENORMOUS PROGRAM IT'S VERY IMPORTANT TO THE STATE OF MARYLAND AND IT'S VERY IMPORTANT TO THE COUNTRY.

MEDICAID IS STATE FUNDED HEALTH INSURANCE FOR LOW INCOME PEOPLE AS OPPOSED TO MEDICARE WHICH IS FOR OLDER ADULTS.

MEDICARE 65 PLUS, MEDICAID LOW INCOME FOLKS BOTH CREATED IN 1965 AND THEY ARE BOTH ENORMOUS BUT MEDICAID IN PARTICULAR IS THE ONE UNDERGOING SIGNIFICANT CHANGES RIGHT NOW.

>> Jeff: HOW MUCH IS MEDICAID EXPANDED?

I KNOW UNDER THE AFFORDABLE CARE ACT OR OBAMACARE, ELIGIBILITY WAS EXPANDED IN MOST BUT NOT ALL STATES.

SO MARYLAND WAS INCLUDED?

>> ELIGIBILITY HAS EXPANDED TREMENDOUSLY.

YES.

AND BECAUSE OF THE AFFORDABLE CARE ACT, NOW, CHILDLESS ADULTS IN THOSE MEDICAID EXPANSION STATES OF WHICH MARYLAND IS ONE, NOW, CHILDLESS ADULTS ARE ELIGIBLE FOR MEDICAID UP TO 138% OF THE FEDERAL POVERTY LEVEL THAT IS 21, 22,000 FOR A SINGLE PERSON.

THESE ARE LOW INCOME FOLKS.

PRIOR TO THAT, IF YOU WERE ME, 42 YEARS OLD IF YOU DON'T HAVE KIDS YOU ARE NOT ELIGIBLE FOR MEDICAID PRIOR TO THE EXPANSION.

SINCE 2014, YEAH, CHILDLESS ADULTS HAVE BEEN ELIGIBLE FOR MEDICAID IN THESE EXPANSION STATES.

>> Jeff: WHO PAYS THE BILL?

IT'S SPLIT BETWEEN THE FEDS AND THE STATE?

>> JUST SO.

THE SPLIT DIFFERS FROM STATE TO STATE N MARYLAND IT'S 50/50.

AND THERE IS A FORMULA THAT DETERMINES THAT IN HIGHER INCOME STATES THE SPLIT IS 50/50.

IN OTHER STATES THE FEDERAL GOVERNMENT PAYS MORE.

HOWEVER, FOR THAT EXPANSION GROUP AND THIS IS IMPORTANT, THE FEDERAL GOVERNMENT PAYS 90% 90 CENTS ON THE DOLLAR THE STATE PAYS 10 CENTS FOR THAT EXPANSION POPULATION.

>> Jeff: AND THAT BRINGS US TO WHAT THE TRUMP ADMINISTRATION WANTS TO DO WITH THE EXPANSION POPULATION, WHICH IS TO ADD WORK OR EDUCATION REQUIREMENTS.

CAN YOU SUM UP WHAT THAT IS AND WHEN IT TAKES EFFECT?

>> CERTAINLY WE ARE TALKING ABOUT SECTION 7111 OF THE HR1 OR ONE BIG BEAUTIFUL BILL.

AND THIS ESTABLISHES SO-CALLED COMMUNITY ENGAGEMENT REQUIREMENTS.

WORK REQUIREMENTS FOR INDIVIDUALS IN THIS ACA EXPANSION GROUP.

SO IT'S ONLY FOCUSING ON THOSE FOLKS THAT GOT MEDICAID COVERAGE BECAUSE OF EXPANSION UNDER THE AFFORDABLE CARE ACT.

IT DOESN'T TOUCH KIDS IT DOESN'T TOUCH PARENTS DOESN'T TOUCH PREGNANT WOMEN ONLY AT THAT TIME EXPANSION GROUP AND STARTING JANUARY 1, 2027, THEY WILL HAVE AS TO BE COMPLIANT WITH THIS COMMUNITY ENGAGEMENT REQUIREMENT WHICH IS A WORK REQUIREMENT.

THEY WILL HAVE TO EITHER BE WORKING AT LEAST 80 HOURS PER MONTH.

OR IN SCHOOL OR DOING COMMUNITY SERVICE OR IN A WORK PROGRAM.

OR THEY RECEIVE AN EXEMPTION FOR ONE OF VARIOUS REASONS.

>> Jeff: HOW ONEROUS IS THIS GOING TO BE IN TERMS OF THE PAPERWORK REQUIREMENT FOR INDIVIDUALS ALSO WHATEVER RECORD KEEPING THE STATE HAS TO DO?

>> I WOULD SAY MODERATELY TO VERY.

NOW, STATES ARE REQUIRED IN STATUTE TO USE ALL AVAILABLE RELIABLE INFORMATION THAT THEY HAVE.

SO THESE ARE THINGS LIKE INCOME DATA BASES, ADMINISTRATIVE HEALTHCARE RECORDS.

STATES WILL BE DOING A ROT OF DATA MATCHING SO THAT THEY CAN DETERMINE WHETHER AN INDIVIDUAL IS COMPLIANT OR NOT WITH THIS COMMUNITY ENGAGEMENT POLICY.

THIS MEANS HOPEFULLY INDIVIDUALS WILL NOT HAVE TO DO MUCH ADDITIONAL REPORTING AT ALL.

THINGS LIKE UPLOADING PAY SLIPS TO A WEBSITE OR SUBMITTING MEDICAL RECORDS THAT IS BEST CASE SCENARIO.

THIS WILL BE BURDENSOME FOR THE STATES THESE SYSTEMS ARE COMPLEX THEY ARE OLD, INCORPORATING THESE NEW DATABASE MATCHES IT IS NO SMALL FEAT BUT THIS IS WHAT STATES ARE BUSY WITH RIGHT THOUSAND.

>> Jeff: YOU SEE A RELATIONSHIP HOW BURDENSOME THE PAPERWORK REQUIREMENT IS AND HOW MANY PEOPLE ARE GOING TO LOSE COVERAGE?

>> 100%.

>> Jeff: AND THE STATE HAS A STRONG INCENTIVE TO NOT LET ANYBODY LOSE COVERAGE BECAUSE ANYONE WHO DOES AND WINDS UP IN THE HOSPITAL FOR SOME REASON, IT'S PROBABLY GOING TO ADD TO UNCOMPENSATED CARE?

>> JUST SO, AND IN MARYLAND WE HVE A UNIQUE SYSTEM OF COURSE WHERE WE ALL SHARE THE BURDEN OF UNCOMPENSATED CARE IN SOME WAYS.

AND YEAH, EXACTLY BECAUSE HOSPITALS THEY HAVE TO TREAT AND STABILIZE INDIVIDUALS BECAUSE OF FEDERAL LAW AGAIN.

AND SO THAT'S EXACTLY RIGHT THE WORRY IS THAT FOLK ALSO LOSE COVERAGE AND THEY WILL STILL GO TO THE HOSPITAL WHEN THEY NEED CARE THEY ARE NOT GOING TO PAY BILLS SO THE UNCOMPENSATED CARE IS GG TO RISE AND HAVE FURTHER DOWNSTREAM IMPACTS UNFORTUNATELY.

>> Jeff: WE TALK ABOUT THE CONFUSION BETWEEN MEDICAID AND MEDICARE THEY STARTED AT THE SAME TIME AND THEY SOUND SIMILAR BUT DIFFERENT PROGRAMS.

MEDICAID, FEWER COPAYS THINGS LIKE THAT.

AND REIMBURSEMENT RATES FOR PHYSICIANS ARE QUITE DIFFERENT, RIGHT?

>> INDEED.

MEDICAID NO COPAYS THERE IS NO PATIENT RESPONSIBILITY.

AND AS OPPOSED TO MEDICARE WHICH THERE ARE COPAYS.

AND PREMIUMS THEY ARE NOT EXPENSIVE BUT THEY ARE REAL.

AND TO GENERALIZE I WOULD SAY THAT THOSE REIMBURSEMENTS THAT MEDICAID PAYS TO DOCTORS AND CLINICS AND IN ALL OTHER STATES HOSPITALS, THEY TEND TO BE LOWER THAN WHAT MEDICARE PAYS.

AND SO THIS RESEARCH ON WHICH PROVIDERS ACCEPT MEDICAID IT IS A BIG ISSUE IT COMES IN AND OUT OF FAVOR IN THE LITERATURES THAT IS AN ONGOING CONCERN.

>> Jeff: HOW READY ARE THE STATES FROM WHAT YOU'VE READ WHAT YOU'VE LEARNED, SPECIFICALLY MARYLAND FOR WHAT IS GOING TO HAPPEN ON JANUARY 1?

>> IT'S DIFFICULT.

IT'S EVEN WITHOUT THIS RECENT INTERIM FINAL RULE RELEASED ON JUNE 1, IT WOULD HAVE BEEN A SPRINT TO GO FROM THE HR1 BEING SIGNED INTO LAW ON JULY 4, STWIF TO GET THINGS SETUP FOR JANUARY 1, 2027.

EASTERN THAT IS PRETTY TIGHT IT WAS DOABLE BUT TIGHT.

RECENTLY RELEASED FEDERAL GUIDANCE HAS CHANGED QUITE SIGNIFICANTLY.

SOME OF THE STATUTORY LANGUAGE I THINK STATES ARE SCRAMBLING RIGHT NOW TO PIVOT AND TRY TO IMPLEMENT THE CHANGES IN THE SYSTEMS IN TIME FOR THE JANUARY 1 GO LIVE.

>> Jeff: YOU'RE PH.D.

IS IN ECONOMICS?

>> YES, SIR.

>> Jeff: WHEN YOU LOOK AT THE AMERICAN HEALTHCARE SYSTEM, AND WE'VE ESTABLISHED A QUARTER OF THE POPULATION IS ON MEDICAID, I DON'T KNOW HOW MANY ON MEDICARE, YOU HAVE A MIX OF OBAMACARE PLANS, YOU HAVE EMPLOYER PROVIDED HEALTH COVERAGE AND AN INCREASINGLY COMPLEX AND EXPENSIVE SYSTEM COMPARED TO THE REST OF THE WORLD.

THERE'S NO EASY FIX TO GET FROM HERE TO SOMETHING THAT MAKES A LITTLE BIT MORE SENSE, IS THERE?

>> NO.

NO.

SADLY, NO.

OUR SYSTEM IS THE LATEST FOR HISTORICAL REASONS DECISIONS MADE IN THE 1920s, 30s, 40s THEY ARE WITH US THEY DETERMINE THE LANDSCAPE.

I THINK THESE PROGRAMS THAT WERE SETUP 60 YEARS AGO, FEDERAL LAWS FROM THE 1970s, AND 80s, THEY HAVE CREATED THESE GRAND FORCES THAT ARE NOW COMPLETELY INTERLOCKING, EXTRAORDINARILY COMPLEX AND IT WILL -- IT'S VERY DIFFICULT TO CHANGE.

I THINK THE HEALTH SYSTEM IT'S EASY TO BE CRITICAL IN THE U.S.

THE QUALITY OF CARE IS GENERALLY GOOD.

THERE ARE HORROR STORIES OUT THERE.

I'M CONCERNED ABOUT THE RISING PRICES.

EVERYONE IS RIGHTLY CONCERNED ABOUT THAT.

AND IT'S I THINK WE HAVE WORK TO DO.

>> Jeff: BEFORE WE GO, ANY ADVICE FOR SOMEONE WATCHING WHO MAYBE IN THAT GROUP OF MEDICAID PARTICIPANTS WHO WILL BE AFFECTED BY THIS NEW LAW?

SHOULD THEY DO SOMETHING AFFIRMATIVELY NOW?

OR WAIT TO HEAR FROM THE STATE?

>> THEY SHOULD DO CALL THEIR STATE MEDICAID AGENCY TRY TO TALK TO A HUMAN BEING AND ASK WHAT GROUP THEY ARE IN.

ASK IF THE WORK REQUIREMENTS APPLY TO THEM.

THEY SHOULD STAY AHEAD OF IT AND ABSOLUTELY MAKE SURE THEY HAVE A CORRECT ADDRESS ON FILE BECAUSE THE IMPORTANT STUFF COMES IN THE MAIL.

ALL OF A SUDDEN YOU TRY TO GET A PRESCRIPTION FILLED AND YOU DON'T HAVE COVERAGE YOU MIGHT HAVE MISSED A LETTER.

SO MAKE SURE YOU HAVE A CORRECT ADDRESS ON FILE AND KEEP AN EYE ON YOUR MAIL.

>> Jeff: MORGAN HENDERSON AT THE HILLTOP INSTITUTE AT UMBC WE THANK YOU FOR YOUR TIME.

AND THAT IS "STATE CIRCLE" FOR THIS WEEK.

JOIN US EVERY WEEK AT THIS TIME FOR THE LATEST ON MARYLAND'S POLITICAL STAGE.

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WE'RE BACK MONDAY WITH "DIRECT CONNECTION" AND YOUR CHANCE TO ASK THE EXPERTS THAT IS MONDAY EVENING LIVE AT 7:00 P.M.

FOR ALL OF US AT MPT THANK YOU FOR WATCHING AND WE'LL SEE YOU BACK HERE MONDAY.

[♪♪]