Trump Administration Moves to Allow States to Impose Medicaid Work Requirements

Pauline Gross
January 12, 2018

For instance, the guidance notes that some Medicaid recipients may have trouble meeting these requirements because of poor health, substance abuse or high unemployment in their areas.

The Trump administration has issued new guidance that would allow states to impose work requirements on low-income healthcare recipients.

In addition, people who are disabled under the Americans with Disabilities Act but have Medicaid benefits for another reason could be exempted, or the state would be required to make "reasonable modifications" such as a reduced hourly requirement to ensure that the requirements don't disproportionately hurt people with disabilities.

"Most people have something to contribute to their community through either work or volunteering, and people who can contribute should do so", LePage said.

It's unclear which states will be the first to pursue a first-of-its-kind Medicaid work requirement waiver.

"This is about helping those individuals rise out of poverty", said Seema Verma, administrator for the Centers for Medicare and Medicaid Services.

Medicaid is the nation's largest public insurance program, providing health benefits to almost 74 million Americans, chiefly low-income adults.

"I think we're building a country of some people who have gotten to the point they feel very comfortable living off of the government", Moul said. If you're "able-bodied", the logic goes, you shouldn't be able to access a free health care program if you don't have a job and help pay into the public system that subsidizes such coverage.

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The Obama administration had declined to offer waivers to states that requested a work requirement.

Ten states have already applied to impose work requirements on adults in the program, with Kentucky potentially ending up being the first state approved.

While some conservatives pressed her agency to quickly issue guidelines, lawyers within the Health and Human Services and Justice departments jockeyed for time to construct a legal justification that they hope can withstand court challenges.

Noam N. Levey is a Los Angeles Times writer.

In an address to Medicaid directors in November, Verma said that with Medicaid being an open-ended entitlement, the program and spending have grown. Demonstrations, which give states additional flexibility to design and improve their programs, are also created to evaluate state-specific policy approaches and better serve Medicaid populations. "We must re-establish Medicaid's core mission of supporting the elderly, disabled and children".

The Obama administration opposed state efforts to implement work requirements in Medicaid because it could result in fewer people having health insurance. Jane Hudson, executive director of the organization, said she is concerned about what would constitute a disability.

Until now, people have not been required to have a job in order to be eligible for Medicaid help.

A survey Kaiser conducted past year said those who weren't working said it was because of an illness or disability, home or family responsibilities, pursuit of an education, retirement or inability to find a job. South Dakota's governor said in his State of the State address Tuesday that he would also look to require certain recipients to work. The revised website content signals a new, broader view of these demonstrations in which states can focus on evidence-based approaches that drive better health outcomes, and quality of life improvements, and support upward mobility and self-sufficiency.

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