States Can Test Medicaid Work Requirements

Lloyd Doyle
January 13, 2018

Louisiana is developing a proposal to impose work requirements on certain adult Medicaid recipients, as the Trump administration announced Thursday it will allow states to enact such provisions.

People who are elderly or disabled, and pregnant women and children, would be excluded.

For the first time, states will be allowed to move toward requiring some Medicaid recipients to work to receive benefits, under new guidelines issued by President Donald Trump's administration Thursday.

"We have a labor force participation problem in the USA and part of it involves people who are in receipt of assistance and not working", Robert Doar, a fellow at the center-right American Enterprise Institute who researches poverty, told NBC News.

"Medicaid needs to be more flexible so that states can best address the needs of this population", said Seema Verma, who oversees the Medicare and Medicaid programs at the Department of Health and Human Services and has long called for putting new requirements on Medicaid patients, including charging them more for their care.

"It is stupid because it will actually prevent people from working - with health needs unattended, many low-income people will be unable to seek work", Robert Weissman, president of liberal advocacy group Public Citizen, said in a statement.

The states are: Arizona, Arkansas, Indiana, Kansas, Kentucky, Maine, New Hampshire, North Carolina, Utah and Wisconsin.

Seema Verma, the agency's administrator, said the policy guidance came in response to requests from at least 10 states that had proposed requiring some Medicaid recipients to work or participate in activities such as skills training, education, job search, volunteering or caregiving.

Among adult Medicaid recipients between age 18 and 64, 60 percent already have jobs, according to the Kaiser Family Foundation health policy research group.

And states are also required to make such accommodations for people with addiction to opioids and other substances.

"This action by the Trump administration goes after people who are just trying to get by", Democratic U.S. Senator Ron Wyden of OR said.

The federal government reimburses a portion of the money spent by states to provide Medicaid coverage for those who are eligible. Indeed, the evidence shows that Medicaid has made people healthier and no less industrious; hence its long history, until now, of broad, bipartisan support.

Advocates for Medicaid beneficiaries said the new policy was likely to be challenged in court if people were denied coverage for failure to meet a state's work requirement. Many Republican-governed states declined to take part in the expansion.

For instance, Kentucky a year ago proposed work requirements for able-bodied adults to get insurance and establishing new fees for all members based on income.

Republicans argue that Medicaid was created to serve the most vulnerable and has become bloated under Obamacare.

An analysis by the nonpartisan Kaiser Family Foundation a year ago found that eight in 10 non-elderly Medicaid recipients were in working families in 2016 with about six in 10 working themselves, leaving an estimated 9.8 million Medicaid recipients who were not working.

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

Other reports by Iphone Fresh

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