Margaret A. Murray, M.P.A., ACAP CEO, on Republicans’ stance on Medicaid

The Association for Community Affiliated Plans (ACAP) opposed the Medicaid provisions included in the Trump administration’s signature legislation, but the safety-net health plan trade group is working to find common ground with the administration on program integrity, according to Margaret A. Murray, M.P.A., ACAP's founding CEO and a longtime member of the Managed Healthcare Executive (MHE) editorial advisory board.

Asked by MHE whether the administration and congressional Republicans are effectively anti-Medicaid, Murray said ACAP “was very much ... not in support” of the changes to Medicaid that the White House and Republicans in Congress pushed through earlier this year, a package that included work requirements, six-month redetermination cycles and higher cost sharing. Even so, she said, CMS has been receptive to her group’s input on program integrity, a term she prefers over "fraud, waste and abuse" because that phrasing overemphasizes fraud. “Sometimes, program integrity is about the appropriate use of resources,” Murray said. “It's not necessarily fraud.”

Murray said ACAP sent CMS a letter describing the steps its member plans are taking to strengthen program integrity, with particular attention to applied behavior analysis services for people with autism that been the target of prosecutions and investigative reporting. She said ACAP’s plans have long focused on ensuring beneficiaries receive the right services, at the right time, from the right provider — work she framed as separate from, and predating, the current political debate over Medicaid spending.

ACAP, which is marking its 25th anniversary this year, represents more than 80 safety net health plans nationwide. Murray said that footprint has shaped how the association has approached Washington under the current administration, staking out positions where it disagrees with the administration and Republicans but not foreclosing discussions on issues such as program integrity.

Despite the association's disagreement with the administration on core Medicaid provisions, Murray said ACAP continues to engage directly with federal officials. “We always want to be able to talk to folks and hope they have an open door for us, and so far, they have,” she said.