Major Shift As Trump Opens Way For Ky.-Backed Medicaid Work Requirement

Trevor Jackson
January 12, 2018

Those states, mostly Republican led, include Arizona, Arkansas, Indiana, Kansas, Kentucky, Maine, New Hampshire, North Carolina, Utah and Wisconsin.

The Trump Administration moved Thursday to allow states to impose work requirements on their Medicaid programs for the first time, the latest adjustment of the nation's health-care system through administrative action after Republican efforts to repeal Obamacare failed previous year.

People with a disability, pregnant women, elderly people, children, and the "medically frail" must also be exempted from the requirement, according to the new rule.

"This new guidance paves the way for states to demonstrate how their ideas will improve the health of Medicaid beneficiaries, as well as potentially improve their economic well-being", said Brian Neale, CMS Deputy Administrator and Director for the Center for Medicaid and CHIP Services.

This would be the first time in the 52-year history of the Medicaid program that there is any sort of work requirement. Lawsuits are expected as individual states roll out work requirements.

Don't be fooled by all the bells and whistles in #Medicaid work guidance.

There are 600,000 Medicaid recipients in Iowa, about 40 percent of whom are aged between 22 to 64, according to the latest quarterly report from the Department of Human Services.

Almost 20 percent of the population received Medicaid benefits in 2015, according to the U.S. census. "That points to the fact that Medicaid can and must do more".

People are not legally required to hold a job to be on Medicaid, but states traditionally can seek federal waivers to test new ideas for the program.

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The new rules will affect "able-bodied, working-age Medicaid beneficiaries" in states that choose to seek waivers in-line with the new guidance.

Want to get all our coverage of Medicaid and the uninsured in your inbox each month? We're giving them the skills and tools they need to have a better life. "We want to give states as much flexibility as possible because that's where we'll be able to evaluate what actually works best".

But several consumer and medical organizations panned CMS's announcement. They are eligible for a waiver request in part because they have agreed to test Medicaid demonstration programs. Cooper's administration hasn't asked for permission to add work requirements to the state's existing Medicaid health insurance program, which covers more than 2 million people.

Of the 9.8 million non-elderly Medicaid enrollees not working in 2016, 36 percent said sickness or inability was their principle goal behind not working, as indicated by the Kaiser Family Foundation.

Before she became the CMS administrator, Verma was a health-care consultant who specialized in helping states redesign their Medicaid programs.

"For those who can not find work, requiring unpaid volunteer work in exchange for health coverage is unconscionable legally and morally, recalling the days of work houses for the poor".

"It is cruel because it not only denies the basic truth that healthcare is a right, it explicitly conditions access to healthcare on wealth". The work requirements will likely be challenged in court. "It is about taking away health insurance from low-income people". "Even worse, it will undermine broad public health priorities" such as the opioid epidemic, he continued.

"Seema Verma has condescendingly talked about combating the "soft bigotry" of low expectations for Medicaid recipients".

Steve Wagner with the Universal Health Care Action Network says there are many reasons why Medicaid beneficiaries may be unemployed, but being unmotivated is not at the top of the list.

Other reports by TheDailyFarc

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