Kentucky Is First State Granted Approval For Medicaid Work Requirements

Lester Mason
January 13, 2018

The federal Centers for Medicare and Medicaid Services said it will allow states to implement work requirements for Medicaid recipients.

Ten states have applied for a federal waiver to add a work requirement - Arizona, Arkansas, Indiana, Kansas, Kentucky, Maine, New Hampshire, North Carolina, Utah and Wisconsin.

The state was among 11 seeking work-requirement approvals from CMS. Kaiser polling a year ago found that 70 percent of the public support allowing states to impose work requirements on Medicaid recipients, even as most people in the USA were against deep Medicaid cuts sought by congressional Republicans and the Trump administration.

Solomon, the advocate for low-income people, said the federal government's waiver authority doesn't provide carte blanche to ignore the basic purposes of the program, and promoting work has not been on that list up to now. The state has one of the highest rates of overdose deaths in the country, and its Medicaid spending on prescriptions for opioid use disorders jumped 326 percent from 2011 to 2016, to $64 million.

Before coming to Washington a year ago, Verma was a health consultant who worked with IN and Kentucky to expand Medicaid under the ACA.

The Bevin administration says it will reach out to enrollees starting Friday, and the program will kick off in July. Most who are not working report reasons such as illness, caring for a family member or going to school.

Even so, the results offer fresh evidence that payment increases can work as intended, particularly in getting physicans who accept Medicaid to take on more patients with this type of coverage, said Judith Solomon, vice president for health policy at the Center on Budget and Policy Priorities in Washington, D.C.

10 states have applied for waivers involving work requirements or community involvement for Medicaid recipients
Kentucky's Medicaid program to see changes after federal government approves Bevin administration's waiver

HHS announced Thursday its intention to allow states to deny Medicaid to otherwise eligible individuals unless they prove that they are working (or participating in related activities) for a minimum number of hours.

Studies have shown that access to Medicaid makes it easier for people to look for work and maintain employment. If an individual already satisfies a work requirement in Supplemental Nutrition Assistance Programs (SNAP or "food stamps") or Temporary Assistance for Needy Families (TANF), then they will automatically satisfy the Medicaid requirement. The failed efforts in the House to replace Obamacare included a work requirement for Medicaid. "Such programs should be created to promote better mental, physical, and emotional health in furtherance of Medicaid program objectives".

If proponents of work requirements are serious about helping people find work, they would invest in skill training and workforce development programs, rather than increasing red tape and making it harder for people to access health care. So are the more than 10 million people on Medicaid because they have a disability.

In comparison, Kentucky seeks to exempt children; pregnant women; primary caregivers for children or a disabled relative; people who are medically frail; and full-time students. "We don't have childless able-bodied working age adults in our system, so I don't know how that would transpose to us".

Pregnant women and children won't have premiums, won't have a change in benefits and won't have to complete the community engagement requirement. Officials in several other states have said they are interested in the idea.

"This is not an option we are considering", said Jennifer Kent, director of the state Department of Health Care Services, which administers Medi-Cal, the state's Medicaid program that covers about 13.5 million Californians.


Other reports by Iphone Fresh

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