Trump Administration Announces State Work Requirements for Medicaid

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Under the Affordable Care Act, states were permitted to expand their Medicaid programs for low-income individuals at or near the poverty line, providing health insurance to those who would struggle to afford coverage even with tax subsidies provided under the law. Under our proposal, people who receive Medicaid and are able bodied will need to work, be training for a new career, or volunteer.

The new Centers for Medicare & Medicaid Services guidance, which allows states to seek federal permission to establish restrictions, could threaten the Medicaid coverage of the many adults with disabilities, children and the elderly who cannot work. "[It's also going] to help people in achieving greater well-being and self-sufficiency".

By tomorrow, states may begin issuing the first-ever work requirements for Medicaid.

The guidance notes that some Medicaid recipients may have trouble meeting these requirements because of frail health, substance abuse or high unemployment in their areas. There's no evidence that Medicaid discourages work, which comports with common sense: You can't pay rent or buy groceries with health coverage.

While Corcoran said the House won't move ahead with the idea this year, the Republican-led chamber considered it last year.

But North Carolina's request applies only if Medicaid expansion, long a political pipe dream for Gov. Roy Cooper and other Democrats, comes to fruition here. Why Is Their Governor Resisting?

That could include counting time spent in medical treatment toward the work requirement, or exempting them from it entirely.

Ten states have asked the agency for flexibility in the Medicaid program, according to Verma.

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Unlike the 1996 rewrite of welfare law, which explicitly mentions work as a goal, Medicaid's law contains no such element, and critics contend rules that could deny people coverage contradict its objectives.

There were almost 2.9 million Pennsylvanians enrolled in Medicaid in November, with 144,971 of those in the Lehigh Valley. The top six industries with the largest number of workers covered by Medicaid include restaurant and food services, construction, elementary and secondary schools, grocery stores and hospitals. While there will supposedly be exceptions for disabled people, allowing states to implement the work requirement is a bad idea.

Medicaid is only available to people over 65, the disabled, and the nation's poorest people who don't get health care any other way. Advocates for the poor warn that the change will result in forcing current recipients off the Medicaid rolls, if they can't meet the work requirements or because they can't jump through the bureaucratic hoops to meet them. Similarly, 60 percent of Nevadans who gained Medicaid coverage via the ACA expansion didn't work at all during 2015.

About 70 percent of Americans say they support states imposing a work requirement on non-disabled adults, according to a Kaiser Family Foundation poll past year. That demand was a rallying cry for Republicans during their unsuccessful attempts previous year to repeal "Obamacare". Additionally, the guidance details that states can not accrue savings from loss in enrollment due to work requirements, which means that states will need to pay for any work requirement administrative burden, such as determining if an individual is working, developing an enrollee reporting system and employment supportive services, etc. Under state work requirements, people have to verify their work status or their qualification for an exemption, according to MaryBeth Musumeci, associate director of Kaiser Family Foundation's Program on Medicaid & the Uninsured.

Included on the extensive list of Arizonans who would be exempt from work requirements are people younger than 19 and older than 55; victims of domestic violence; individuals with serious mental illness; American Indians; people who are homeless; former foster youths up to the age of 26; pregnant women; full-time students; people recently impacted by a death or catastrophic event; and caregivers of a family member enrolled in the Arizona Long Term Care System, the application states.

'Medicaid needs to be more flexible so that states can best address the needs of this population, ' Verma said in a statement.

A recent study by the Foundation for Government Accountability highlights why implementing requirements that able-bodied Medicaid enrollees work, at least on a part-time basis, would be appropriate for states like Nevada.


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