Trump to let states pursue work requirements for Medicaid

Sergio Conner
January 13, 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. Rep. Travis Cummings, R-Orange Park, introduced a bill that would have required all Medicaid beneficiaries who are part of the state's "managed medical assistance" program to adhere to the same work requirements that now apply to families who receive temporary cash assistance.

Yet states considering whether to enact the controversial strategy face major hurdles. If a person had Medicaid for three months or more for the past five years, he or she will go straight into the work requirement. As stressed by the administration: "To achieve the objectives of Medicaid, state programs should be created to promote better physical and mental health".

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

But the state today doesn't know how many of its enrollees are already employed, said Snyder.

While the Trump administration signaled willingness this week to allow work requirements for Medicaid beneficiaries, the Florida Legislature is unlikely to move ahead with such a mandate this year. That Medicaid expansion was sharply criticized by conservatives, and Republicans in Congress tried to add work requirements in their unsuccessful bid a year ago to overturn the health law.

Such able-bodied adults were not eligible for Medicaid in New Hampshire prior to the 2014 expansion, which has led to an additional 50,000 enrollees.

Hunter also said there will be a few ways people will be designated medically-frail: through a diagnosis, health insurance claims, or a doctor or the enrollee attesting to the medically-frail status.

Because people got needed care, the report found that they were able to work more steadily.

People who gained coverage through Medicaid expansion (who can make up to $16,670 for a one-person family) will have to pay a copay or premium. And when someone gets sick, the last thing she needs to worry about is whether she'll also lose her health coverage for not working. But Rosenbaum notes the absurdity of arguing that keeping people from health care will make them more likely to be able to work. Medicaid expansion is exactly that type of policy. The federal Centers for Medicare and Medicaid Services made the announcement Thursday. That includes getting a job, going to school, taking a job training course and community service.

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Thursday's administration guidance to states spells out safeguards that states should consider in seeking work requirements.

Bevin has said the program had become financially unsustainable under Obamacare, although the federal government covers the majority of its cost.

The elderly, disabled, children and pregnant women would be excluded from the requirements.

Some Democratic-leaning states are not expected to make the change.

Medicaid is a federal-state collaboration covering more than 70 million people, or about 1 in 5 Americans, and that makes it the largest government health insurance program.

Kevin de León, a Democrat and the leader of California's Senate, wouldn't comment on the proposal because he said it's a non-starter. And the proportion of doctors taking at least as many Medicaid as privately insured patients climbed nearly 6 percentage points to about 56 percent.

The Obama administration turned down several state requests to add a work requirement. About 52 million of the 74 million Medicaid enrollees rely on managed-care companies for their coverage.

Kentucky's waiver, submitted for federal approval in 2016, requires able-bodied adult recipients to participate in at least 80 hours a month of "employment activities", including jobs training, education and community service.

Jeff Myers, president and CEO of the Medicaid Health Plans of America, another trade group, noted that most people on Medicaid already work. That leaves plenty of chances to fall through the cracks of a work requirement. They will need to "see all of details from states", he said.

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