Kentucky is 1st to get OK for Medicaid work requirement

Pauline Gross
January 13, 2018

Aides to Gov. Bevin estimated that roughly half of 350,000 Kentucky Medicaid recipients already meet the new Medicaid requirements to work at least 80 hours per month, volunteer, or commit to job training. People working 120 hours a month are also exempt.

"The action appears created to achieve significant cuts in Medicaid enrollment rather than Medicaid's stated goal of furnishing medical assistance to low-income people", NHeLP Legal Director Jane Perkins said. The agency is expected to start approving state waivers promoting "community engagement activities" in coming weeks. One of those states was Arkansas.

While the Trump administration signaled willingness this week to allow work requirements for Medicaid beneficiaries, the Florida Legislature is unlikely to move ahead with such a mandate this year.

Trump's new direction can be reversed by a future administration. "Implementing co-pay and employment hurdles will increase administration costs and will inadvertently reduce access to health care for consumers in great need". "We know from studies that this kind of requirement doesn't work; it doesn't help people get jobs". "Those days are over". Those states include Kentucky, Maine, New Hampshire, Arizona, Indiana and Utah. It allowed states to provide coverage to anyone earning up to 138 percent of the federal poverty level (about $16,600 for an individual).

"We're really optimistic that we'll get official waiver approval very soon", she said.

The Illinois Department of Healthcare and Family Services said Thursday that the "policy notice and its implications are under review". Among such enrollees, 90 percent were unemployed because they were ill or disabled, retired, taking care of their home or family, or attending school.

Liberal-leaning groups had already hinted at challenging Medicaid work requirements in court before the Kentucky waiver was approved, and some of those same groups harshly criticized at the policies in the state's demonstration project.

The policy change would mark the first time the publicly funded program, which has insured the health needs of the poor and disabled since its creation in the 1960s, has been allowed to require work for benefits. Kevin de León, a Democrat and the leader of California's Senate, wouldn't comment on the proposal because he said it's a non-starter. Imposing a work requirement as a condition for people to receive public health insurance support could be the sparks that lights a fire and gets someone to decide to make those changes.

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"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", Brian Neale, CMS deputy administrator and director for the Center for Medicaid and CHIP Services, said in the press release. "For example, higher earnings are positively correlated with longer life span".

"Medicaid is a health care program", he said. They could also work as volunteers at food pantries and other charitable organizations.

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.

Medicaid has played a big role in combating the opioid epidemic, paying for a wide range of treatments and medications. History from other programs shows people who are working and those who should be exempt lose benefits. "So the potential for work in our neighborhood without having to take a bus significant distance and time out of the neighborhood is going to be a challenge", she said.

"They are illegal and not permissible under law", said Leonardo Cuello, a lawyer with the Washington-based National Health Law Program, which anticipates filing a lawsuit challenging Kentucky's plan. The requirement doesn't apply to those with disabilities, the pregnant, or the elderly. It also encourages an exemption for people who are deemed "medically frail".

The Obama administration didn't reject every request for change.

This Kaiser Health News story can be republished for free (details).

In his State of the State address Tuesday, Gov. Phil Bryant of MS, a Republican, said he supported a "workforce requirement" for able-bodied adults on Medicaid.

Other reports by GizPress

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