Baker: Massachusetts won't impose Medicaid work requirement

Power outage causes attendees to evacuate Central Hall at CES in Las Vegas on Wednesday Jan. 10th 2018

The new policy comes as 10 states are already lined up, waiting for federal permission to impose work requirements on able-bodied adults in the program. The vast majority of those who aren't working have an illness or disability, are caring for a family member, or are in school.

Sixty percent of Medicaid's non-elderly adults already work, according to a recent analysis of census data by the Kaiser Family Foundation. The main impact of the rules will be to subject poor people to stacks of paperwork that will drive some to drop coverage, the critics say.

How the new policy affects providers is so far unknown.

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

Lead author Renuka Tipirneni, M.D., M.Sc., a U-M assistant professor of internal medicine, is available to discuss the results and how they might inform the national and state-level discussion about requirements such as those laid out by CMS.

"As an example in the TANF program, the cash assistance program, there is authorization to include work limits and work requirements, and there is no such requirement in the Medicaid law", said Berg.

Medicaid covers about half of the babies born in this country, she said. Many Medicaid enrollees may have physical or mental health problems - such as arthritis or asthma - that don't meet the criteria for federal disability programs, but still interfere with their ability to work, Kaiser said.

Section 1115 of the Social Security Act gives the Secretary of Health and Human Services authority to approve experimental, pilot, or demonstration projects determined by the Secretary to be likely to assist in promoting the objectives of the Medicaid program. "Health care should be a right, not a privilege".

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

"We have an opportunity to reshape our program and tailor it to best serve the needs of our state", said Mayhew, who is seeking the Republican nomination for governor this year.

"So I think you take those recommendations, embed it in, put it back on the Governor's desk and let him explain to taxpayers why people who are capable of working are not working", said Rep. Seth Grove, (R) - York County.

Health insurance reforms initiated during Barack Obama's presidency raised the income cap for access to Medicaid, allowing millions of low-income earners to join the Medicaid rolls.

Democrats are opposed to the changes and are expected to sue, arguing the administration does not have the power to make them without action from Congress, a view shared by Joel Berg, CEO of the New York-based nonprofit Hunger Free America.

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. We know from experience with work requirements in Temporary Assistance for Needy Families and SNAP (formerly food stamps) that large numbers of people lost benefits because the state decided they hadn't met various paperwork requirements to show they were working or unable to work or they experienced other barriers to proving they were exempt from the requirement. In the end, that state included in its Medicaid expansion only an encouragement of voluntary efforts by beneficiaries to train for work or find jobs.

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