Trump Administration Clears Way To Require Work For Some Medicaid Enrollees

Trump Administration Clears Way To Require Work For Some Medicaid Enrollees

Kentucky on Friday became the first US state to require that Medicaid recipients work or get jobs training, after gaining federal approval for the fundamental change to the 50-year-old health insurance program for the poor. "Our fundamental goal is to make a positive and lasting difference in the health and wellness of our beneficiaries".

In a major policy shift that could affect millions of low-income people, the Trump administration said Thursday it is offering a path for states that want to seek work requirements on Medicaid recipients.

The state will still have to apply for a waiver and undergo the full federal review process, but CMS will now support state efforts to "test incentives that make participation in work or other community engagement a requirement for continued Medicaid edibility", according to the January 11 letter.

Studies have shown that access to Medicaid makes it easier for people to look for work and maintain employment.

Former governor Steve Beshear originally expanded Kentucky's Medicaid program to include people making up to 138 percent of the poverty limit after the Affordable Care Act passed in 2010, setting up a funding stream for states to expand the program for low-income Americans.

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. He says it does not apply to anyone receiving Medicare or the traditional Medicaid recipient.

"Among adults with Medicaid coverage, almost eight in 10 live in working families and a majority are working themselves", he said.

"There's never been a work requirement in Medicaid, it's only been in recent years that states have raised the possibility of having one", she said.


Conservatives, however, hailed the change to the federal-state program for low-income people. The new policy allows states to make exceptions to the work rules for caregivers and students, but it doesn't require that they do so. According to government statistics, 60 percent of non-disabled, working-age adults having a job, while almost 80 percent live with families that have at least one member in the labor force.

Such able-bodied adults were not eligible for Medicaid in New Hampshire prior to the 2014 expansion, which has led to an additional 50,000 enrollees.

Kentucky's program would require non-disabled adults each month to participate in 80 hours of work, job training, education or other qualified "community engagement".

The administration said states must fully comply with federal disability and civil rights laws, to accommodate disabled people and prevent those who are medically frail from being denied coverage.

Thursday's administration guidance to states spells out safeguards that states should consider in seeking work requirements.

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.

The majority of enrollees in Medicaid are children, pregnant women and elderly nursing home residents.

A bipartisan commission appointed to study the issue over the summer, led by Majority Leader Jeb Bradley, R-Wolfeboro, recommended that the program be continued but left numerous details to lawmakers - including how the state will pay for its 10 percent share of the expansion in 2020 and beyond.

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