Margaret A. Murray, M.P.A., the founding CEO of the Association for Community Affiliated Plans (ACAP), says the group disagrees with the Trump administration and congressional Republicans on the core provisions of the recent Medicaid overhaul. The package, pushed through earlier this year, included work requirements, six-month redetermination cycles, and higher cost sharing. Murray told Managed Healthcare Executive that ACAP was “very much … not in support” of these specific changes.
Seeking common ground on program integrity
Despite the friction over spending and eligibility rules, Murray said the association is finding room for collaboration with the administration. The group has shifted its focus to program integrity, a term Murray prefers over “fraud, waste and abuse” because she believes the latter phrase overemphasizes criminal wrongdoing. “Sometimes, program integrity is about the appropriate use of resources,” she said. “It’s not necessarily fraud.” This distinction is key, as it acknowledges that program integrity issues can arise from a variety of factors, including administrative errors or misunderstandings, rather than solely from intentional misconduct.
ACAP sent a letter to the Centers for Medicare & Medicaid Services (CMS) detailing the steps its member plans are taking to strengthen oversight. The letter highlighted efforts to monitor applied behavior analysis services for people with autism, a service that has faced recent scrutiny from prosecutors and investigative reporters. Murray noted that these plans have long focused on ensuring beneficiaries receive the right services at the right time, a mission she framed as separate from the current political debate over budget cuts. By emphasizing the importance of timely and appropriate care, ACAP is showing the need for a subtle approach to program integrity, one that balances the need to prevent waste and abuse with the need to ensure that beneficiaries receive the care they need.
The group represents more than 80 safety net health plans nationwide, marking its 25th anniversary this year. Murray said this broad membership has forced the association to handle a complex political setting under the current administration. The organization has staked out clear positions where it disagrees with the White House and congressional Republicans, yet it has avoided shutting down dialogue on shared interests. This approach reflects ACAP’s commitment to finding common ground and working collaboratively with federal officials, even in the face of significant policy disagreements.
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Engagement with federal officials remains a priority for ACAP despite the disagreements. “We always want to be able to talk to folks and hope they have an open door for us, and so far, they have,” Murray said. The association continues to maintain these direct lines of communication as it balances its role as a critic of certain policies with the need to advocate for its members’ operational realities. By maintaining open channels of communication, ACAP is able to provide feedback and guidance to federal officials, helping to shape policy and ensure that the needs of its members and the beneficiaries they serve are taken into account.
ACAP’s efforts to strengthen program integrity are also reflective of its broader commitment to ensuring that safety net health plans are able to provide high-quality, effective care to their beneficiaries. By focusing on the appropriate use of resources and the timely delivery of care, ACAP is helping to promote a culture of accountability and transparency within the Medicaid program. This, in turn, can help to build trust and confidence in the program, which is essential for ensuring that beneficiaries receive the care they need and that taxpayer dollars are being used efficiently and effectively.
The association’s 25th anniversary is a significant milestone, marking a quarter century of advocacy and support for safety net health plans. Throughout its history, ACAP has worked tirelessly to promote the interests of its members and the beneficiaries they serve, providing a voice for the safety net community in Washington and helping to shape policy and regulatory decisions. As the Medicaid program continues to evolve and face new challenges, ACAP’s leadership and expertise will be essential in ensuring that the needs of safety net health plans and their beneficiaries are taken into account.
