States can force 'able-bodied' to work for Medicaid, rules Trump administration

Opponents Call to Restore Funding to Medicare Medicaid

The Trump administration took a significant step Thursday toward letting states set up work requirements for people on Medicaid, the program that covers health care for millions of Americans.

Many Medicaid recipients are already employed.

"Those are the people who need Medicaid coverage the most, because the rely on it". "As our letter explains, the administration is making an about face in its efforts to overturn established [Department of Health and Human Services] policy against work requirements without public comment".

Ten states so far have submitted proposals for the work requirement waivers: Arizona, Arkansas, Indiana, Kansas, Kentucky, Maine, New Hampshire, North Carolina, Utah and Wisconsin.

Also protected would be Medicaid enrollees who are too ill to work, especially because of a drug addiction. In addition to the 268,000 Mainers now on Medicaid, another 70,000 could become eligible as a result of November's popular vote to expand the program to childless adults.

Obamacare Enrollment Is Up Over Same Period in 2016
Obamacare Enrollment Is Up Over Same Period in 2016

The state estimates about 30 percent of current recipients would have to comply.

"The Trump administration is on wobbly legal ground in trying to limit Medicaid enrollment by imposing onerous work requirements", Perkins said in a statement. "The most vulnerable people are the ones who need Medicaid coverage the most, and they will lose it", Pavetti said. However, if states align their work requirements with existing systems, such as those used with TANF and SNAP, it could decrease administrative costs.

Kaiser polling previous year found that 70 percent of the public support allowing states to impose work requirements on Medicaid recipients, even as most people in the USA were against deep Medicaid cuts sought by congressional Republicans and the Trump administration. States will therefore be required to describe strategies to assist eligible individuals in meeting work and community engagement requirements and to link individuals to additional resources for job training, provided they do not use federal Medicaid funding to finance these services. Unless states have significant research to show Verma's correct on causality, they may have a very hard time in federal court attempting to get clearance on this new executive override of Medicaid statutes.

Jezebel reported Thursday that 60 percent of Medicaid's non-elderly recipients already have jobs, according to a study by the Kaiser Family Foundation.

Under the 2010 Affordable Care Act, former Democratic President Barack Obama's signature domestic policy achievement commonly known as Obamacare, 31 states expanded Medicaid to those making up to 138 percent of the federal poverty level, adding millions of people to the rolls. Notably, among adults with Medicaid coverage, almost 8 in 10 live in working families and a majority are working themselves.

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But congressional Democrats and advocates said the Trump administration is moving in the wrong direction.

The Trump administration said that state Medicaid officials could not impose work requirements on pregnant women, elderly beneficiaries, children or people who were unable to work because of a disability.

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

Arizonans who don't qualify for an exemption would have to work, be actively looking for work, or be in school or job training for at least 20 hours per week.

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Sovereign Hager, an attorney with the New Mexico Center on Law and Poverty, said that the waiver New Mexico recently sent to the federal government does not include any provisions for work requirements.

CMS wants states to make sure their work requirements are similar to the ones they have for food-stamp and welfare programs, to avoid confusion and make sure the proposals run efficiently.

"An analysis of Ohio's Medicaid expansion found that over half of enrollees who are working (without being required to do so) reported that having Medicaid made it easier for them to continue working", the foundation analysis says.

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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