Trump Administration Moves to Allow States to Impose Medicaid Work Requirements

Health and Human Services Secretary Marylou Sudders speaks during a news conference announcing more reforms to combat the opioid crisis at the State House Tuesday

Trump Administration Moves to Allow States to Impose Medicaid Work Requirements

-Allowing people under treatment for substance abuse to have their care counted as "community engagement" for purposes of meeting a requirement. "They're trying to be responsive to states".

Steve Wagner with the Universal Health Care Action Network says there are many reasons why Medicaid beneficiaries may be unemployed, but being unmotivated is not at the top of the list.

States are required to provide eligibility modifications for appropriate enrollees and exempt individuals determined to be medically frail or have an acute condition that would prevent participation.

A University of MI team recently published data in JAMA Internal Medicine from detailed survey of more than 4,000 MI residents enrolled in the state's expanded Medicaid program.

Technically, those waivers would be 'demonstration projects.' In practical terms, they would represent new requirements for beneficiaries in those states.

Still, critics fear a work requirement could have a chilling effect on people signing up for Medicaid or make it harder for people to get coverage.

As of October 2017, almost 75m individuals were enrolled in Medicaid and the children's health insurance program (Chip).

"I see this as CMS giving states that are looking for flexibility, flexibility", Sudders said, using the acronym for the Centers for Medicare and Medicaid Services. Consumer advocates and health policy experts fear that such a requirement could prove a big hurdle for many recipients, leaving them without the care they need.

Medicaid has expanded over the years beyond the impoverished, to cover people in nursing homes and newborns.

CMS said the new policy seeks to help improve the economic situation of Medicaid recipients. "It's not a good idea, and it's illegal".

"The goal should be to assist folks, who are able bodied, to become members of the work force". It's a little like saying that rain causes clouds.

"Most people on Medicaid who can work, do so", the coalition wrote, "and for people who face major obstacles to employment, harsh requirements won't help them overcome them".

"The new [state programs] will penalize individuals by having them lose health coverage, rather than incentivize them, as a voluntary program with adequately funded supportive services necessary to overcome barriers, would", she said.

Calling the new policy "unconscionable and illegal", Eliot Fishman, senior health policy director at the liberal consumer health lobby Families USA, said in a statement: "Today's announcement isn't about work".

According to Politico, in 2014 Obamacare allowed states to offer healthcare coverage to low-income individuals who suffered no debilitating medical problems.

In a CMS call with reporters Thursday morning, Verma countered, "This policy is about helping people achieve the American Dream".

"There are a lot of different ideas, and a lot of ways to go about this", she said.

Like the policy the Trump Administration announced Thursday, the proposal has exceptions for pregnant women, elderly beneficiaries, children and people unable to work because of a disability.

Of the 9.8 million non-elderly Medicaid enrollees not working in 2016, 36 percent said sickness or inability was their principle objective behind not working, as indicated by the Kaiser Family Foundation.

Sen. Joyce Krawiec, R-Forsyth, said she supports the work and community service requirement because "I believe that most people think it's appropriate to require certain able-bodied recipients to work, volunteer or receive training".

It will allows states to deny Medicaid to able-bodied adults without a job, according to reports.

This would be the first time in the 52-year history of the Medicaid program that there is any sort of work requirement. "If we had fewer sick people and fewer poor people, that'd lower the Medicaid rolls". For low-wage workers, such as waitresses with fluctuating wages, "it boggles my mind", Stewart said.

A Health Affairs analysis found that if work requirements were applied to Medicaid nationwide, 11 million enrollees would be at risk of losing coverage. Many Republican-governed states declined to take part in the expansion.

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