Feds issue guidance so states can pursue Medicaid work requirement

Katrina Barker
January 12, 2018

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.

"I think the Cooper Administration recognized the reality that, to have any viability, their expansion proposal had to have work requirements", Curtis Venable, an attorney who specializes in Medicaid at Ott Cone & Redpath, said Thursday.

In order to implement any new policy based on the guidance, states would have to propose the changes through waivers and wait until they are granted federal approval.

"Access to Medicaid makes it easier for people to look for work and obtain employment", Wikle said.

Pregnant women, the elderly, individuals with disabilities or other health issues preventing work and, victims of domestic violence would be exempted from the new guidance, according to the letter from the Centers for Medicare & Medicaid Services (CMS). They say the move doesn't meet the objectives of the Medicaid waiver program, and Democratic groups are expected to file lawsuits over Medicaid work requirements.

Ten states - Arizona, Arkansas, Indiana, Kansas, Kentucky, Maine, New Hampshire, North Carolina, Utah, and Wisconsin - have proposed adding requirements for work or community engagement, according to CMS.

Kentucky will likely become the first state to receive a waiver, which could happen as soon as Friday, the Washington Post reported. Signed into law in 1965 as part of the Social Security Act, #Medicaid was born in the attempt to "provide health coverage for low-income people", as stated on the Medicaid website.

"The governor believes that Medicaid is an important safety net for many Iowans, and her hope is that those on the program who are able-bodied are able to find a career and re-enter the workforce", Smith said in an email.

Seema Verma, CMS' administrator, said in a statement that the controversial plan aims "to improve Medicaid enrollee health outcomes by incentivizing community engagement among able-bodied, working-age Medicaid beneficiaries".

Critics say the rules could mean more Americans are left without health insurance.

'There's never been a work requirement in Medicaid, it's only been in recent years that states have raised the possibility of having one, ' she said.

The administration contends the policy is to promote "community engagement".

Echoing Bruenig in a tweet on Wednesday, Roosevelt Institute fellow Michael Linden concluded, "There is perhaps no better example of the moral rot at the core of the Republican Party than imposing so-called "work requirements" on sick Medicaid recipients just weeks after passing a massive tax cut for rich heirs who literally did no work at all to inherit their wealth".

The policy would exclude individuals who are elderly or disabled, pregnant women and children.

"M$3 ore than one-third of Medicaid beneficiaries who aren't working report that illness or a disability is the main reason, 28 percent report that they're taking care of home or family, and 18 percent are in school", reports the Center of Budget and Policy Priorities.

As of October 2017, almost 75m individuals were enrolled in Medicaid and the children's health insurance program (Chip). 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. That's because children - who make up almost half of Medicaid enrollees - are excluded.

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.

Other reports by AllAboutTopnews

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