Trump to let states pursue Medicaid work requirements

Centers for Medicare and Medicaid Services administrator during her Senate Finance Committee confirmation hearing in Washington on Feb. 16 2017. MUST CREDIT Bloomberg

This Kaiser Health News story can be republished for free ( details ). He said it's not clear what problem a Medicaid work requirement would solve, and that there are better ways to help people find jobs or reduce the number of people receiving Medicaid.

"Medicaid was designed as a health care program, to provide vulnerable members of our society with access to care they badly need", said Dr. Jack Ende, president of the American College of Physicians. “This policy helps people achieve the American dream.”.

House Republicans in Harrisburg are still seeking a work requirement for Medicaid, and included the concept in a package of welfare reform proposals announced last week.

Ten states, mostly conservative ones, have applied for waivers involving requirements for jobs or community involvement for most Medicaid recipients. It also suggests that states take into account the local availability of jobs in creating requirements.

Second, it would shore-up Nevada's labor force participation - which has been hovering around historic lows - as unemployed enrollees return to the labor market for the objective of maintaining their Medicaid coverage. It covers roughly 70 million people, or 1 in 5 Americans, and pays for everything from births to nursing-home care for senior citizens.

Brian Neale, the director of the federal Medicaid office, defended the Medicaid work requirements, saying that "Productive work and community engagement may improve health outcomes", and that researchers have found "strong evidence that unemployment is generally harmful to health", while employment tends to improve "general mental health".

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.

Bullard said it shouldn't matter what someone's situation is - they deserve health care coverage regardless. Why Is Their Governor Resisting? It's unclear how numerous remaining able-bodied recipients would fall under the new requirements.

Kentucky, which has some of the poorest counties in the country, has seen its Medicaid enrollment double in the past three years after the state expanded eligibility under the ACA. Thats because children — who make up almost half of Medicaid enrollees — are excluded.

"Should eligible Medicaid recipients be looking for work or be trying to work?"

To be approved for a waiver, states have to show that their plan is revenue neutral. Barring the possibility that they find an employer sympathetic to his or her special needs, the only way to get out of this in-between space is to eventually become sick or disabled enough that they are eligible for Medicaid. "That there is no room in the Medicaid program for a work requirement, and that this is really just an attempt by the administration to push people off the Medicaid program and penalize them". They will be exempt from the new requirements.

The administration's new approach - one that no administration before it has taken - is to provide waivers to states that allow them to impose work requirements for Medicaid benefits.

Advocates for the poor and Democrats are likely to pan the move.

Some Republicans pointed Thursday to the suddenly aligned policies of Cooper and President Donald Trump, congratulating him on joining their side of the issue, but foregoing any promise to actually back his Medicaid expansion pitch.

The CMS guidance gives states a great deal of flexibility to define their own exceptions to a work requirement, as well as what counts toward work.

But Trump administration officials said Thursday that work requirements were consistent with the goals of Medicaid, because work and work-related activities could improve the health of Medicaid beneficiaries.

"Medicaid needs to be more flexible so that states can best address the needs of this population", CMS Administrator Seema Verma said in a statement Thursday.

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.

Currently, 10 states have applications pending that ask for permission to include some type of work requirement: Arizona, Arkansas, Indiana, Kentucky, Maine, Kansas, North Carolina, New Hampshire, Utah, and Wisconsin.

CMS also encourages states to consider a range of activities that could satisfy work and community engagement requirements.

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