Feds issue guidance so states can pursue Medicaid work requirement

Feds issue guidance so states can pursue Medicaid work requirement

This Kaiser Health News story can be republished for free ( details ).

The conditions would exclude individuals eligible for Medicaid due to disability, elderly beneficiaries, children and pregnant women.

Under federal law, Medicaid waivers have to support the program's objectives by increasing coverage or health outcomes for people on Medicaid. These are individuals who are physically capable of being actively engaged in their communities, whether it be through working, volunteering, going to school or obtaining job training.

Andrea Callow, associate director of Medicaid initiatives at nonprofit Families USA, sees the new policy as a shift in strategy by the Trump administration to undercut the Medicaid program after efforts to weaken it failed during attempts to repeal "Obamacare".

"They want to push people off medicaid and... give states... the option to tell people that you can't be on Medicaid because you're not working", Gerisch said.

The work requirements will likely have an impact on a broad number of adults. As I talk to Medicaid recipients, they want to get off public assistance; they want to have a better life.

Republicans have been pushing for the change since the Affordable Care Act added millions of “able-bodied” adults to Medicaid.

The state has had problems with federal aid in the past.

Federal officials also argued that work requirements would help to combat depression.

Ten states-Arizona, Arkansas, Indiana, Kansas, Kentucky, Maine, New Hampshire, North Carolina, Utah, and Wisconsin-said they are interested in trying out enforcing work for Medicaid.

All the policy will do, Berg said, is increase bureaucracy and paperwork, "supposedly from the small government people", because it will force working people to leave work, or those on a job search to stop searching and have to go to a government office to fill out a form to show they are working or searching for a job.

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"A majority of adults covered by Medicaid who can work, do work - often two or three jobs in fields like the service industry that are less likely to offer insurance", Woodhouse said.

The Trump administration has signaled from the outset that it wanted to set a more conservative tone for Medicaid, a 1960s-era program that was part of Lyndon Johnson's anti-poverty Great Society. Thats because children — who make up almost half of Medicaid enrollees — are excluded. Medicaid is a fundamental avenue for health care for numerous nation's poor.

Democrats and health advocacy groups blasted the policy and said it would make it more hard for the most vulnerable Americans to have access to healthcare services.

Some Democrats and advocacy groups have said they would sue to block any new work requirement plans that CMS approves, Politico reported. CMS also said it will help states align Medicaid work and community engagement requirements with SNAP or TANF requirements. It has also helped people work: Studies of Medicaid expansion in OH and MI found that the majority of beneficiaries said that getting health coverage helped them look for work or remain employed.

But work requirements have strong public backing.

Although the announcement says states must protect people who can't meet a work requirement because of illness or disability, don't hold your breath.

The Trump administration has rejected that logic.

The Trump administration will allow states to create work requirements for some Medicaid recipients for the first time, in what The Wall Street Journal calls "one of the biggest changes in the program's 50-year history".

"Our policy guidance was in response to states that asked us for the flexibility they need to improve their programs", Verma said in a statement.

Verma, who served as a Medicaid consultant for IN and Kentucky before joining the Trump administration, has long advocated for work requirements.

But according to Callow with Families USA, the new policy might not sustain court challenges.

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