Proposed Work Requirements in Medicaid

Kentucky Gov. Matt Bevin left and President Trump during a prison reform roundtable on Thursday

The Trump administration early Thursday initiated a pivotal change in the Medicaid program, announcing that for the first time the federal government will allow states to test work requirements as a condition for coverage.

"This new guidance paves the way for states to demonstrate how their ideas will improve the health of Medicaid beneficiaries, as well as potentially improve their economic well-being", CMS Deputy Administrator and Director for the Center for Medicaid and CHIP Services Brian Neale said.

According to Governor LePage healthy adults who can contribute by either working or volunteering should do so and that will help people break the cycle of poverty.

A study by the Kaiser Family Foundation found that 6 in 10 non-disabled adults on Medicaid already work at least part time, although they often aren't offered health benefits through those jobs or can't afford them.

However some IL patient advocates say they hope the state doesn't submit a proposal to make having a job a condition of Medicaid eligibility, citing fears it would leave people without health insurance.

Congressman Bruce Poliquin is for it. Democrats, health providers and patient groups say the measure adds another stumbling block for people to keep their coverage. In the remaining, only a small number of people will be subject to the requirements.

"Medicaid needs to be more flexible so that states can best address the needs of this population".

The work requirement is one of the biggest changes in the history of Medicaid, which covers more than 74 million people, or about 1 in 5 Americans.

Health & Family Services Secretary Vickie Yates Glisson says the Kentucky HEALTH program will start in July, and that it is not a "one size fits all" solution.

Enrollees who will be exempt from this include full-time students, former foster care youth, pregnant women, people with an acute medical condition and primary caregivers. Kentucky's new program will improve the health of its participants, strengthen Medicaid's long-term fiscal sustainability, and promote personal responsibility for health and well-being.

Bevin unveiled the demonstration waiver known as Kentucky HEALTH June 22, 2016. And over one-third of working-age Medicaid recipients not working are unemployed because of illness or disability. But many of those would drop out not because of finding work but because they can't overcome the new bureaucratic hurdles, say advocates for the poor.

For people in exceptionally vulnerable positions - say, someone who just lost his job after failing a drug test and can't find an available space at a substance abuse program in his area - adding another bureaucratic hurdle could make it even more hard to get back on track.

Before coming to Washington past year, Verma was a health consultant who worked with IN and Kentucky to expand Medicaid under the ACA. According to government statistics, 60 percent of non-disabled, working-age adults having a job, while almost 80 percent live with families that have at least one member in the labor force. But in a speech to the nation's Medicaid directors in November, Verma said adding non-disabled adults to Medicaid was a mistake for a program created to help children, the disabled and pregnant women. That leaves plenty of chances to fall through the cracks of a work requirement.

The majority of enrollees in Medicaid are children, pregnant women and elderly nursing home residents.

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