Published: Fri, January 12, 2018
World | By Melba Underwood

States Can Test Medicaid Work Requirements

States Can Test Medicaid Work Requirements

Far from requiring full-time work hours, the new policy states that eligible individuals will spend twenty hours a week in work-related activities, which may include job training or treatment for opioid addiction.

Critics say the rules could mean more Americans are left without health insurance.

The orders would mark a significant shift in how the Medicaid program, government health care for low-income people, is administered.

Seema Verma heads the Centers for Medicare and Medicaid Services, and she announced the new approach on Thursday in Washington, D.C. She says work and community involvement can make a positive difference in people's health.

For close to a year, the administration has signaled an interest in helping states that want to institute work requirements.

Republicans have long wanted to add work requirements to the Medicaid program, which covers almost 75 million low-income children, adults, elderly and disabled Americans.

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 must also fully comply with federal disability and civil rights laws and ensure that all individuals with disabilities have the necessary protections to ensure that they are not inappropriately denied coverage.

Arizona, Arkansas, Indiana, Kansas, Kentucky, Maine, New Hampshire, North Carolina, Utah and Wisconsin already filed applications to add the work requirements, according to NPR. OH has previously proposed a similar requirement, which was rejected by the Obama administration.

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. Most who are not report reasons such as illness, caring for a family member or attending college. South Dakota's governor said in his State of the State address Tuesday that he would also look to require certain recipients to work.

Many recipients already have jobs that don't provide health insurance and people are not legally required to hold a job to be on Medicaid.

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The requirements will likely be subject to court challenges.

"I don't know that that one change would make any sort of fundamental change", House Appropriations Chairman Nelson Dollar, R-Wake, said.

Section 1115 of the Social Security Act gives the Secretary of Health and Human Services authority to approve experimental, pilot, or demonstration projects determined by the Secretary to be likely to assist in promoting the objectives of the Medicaid program.

"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". Any work requirements would only apply to "able-bodied" adults with exemptions for children, the elderly and people with disabilities.

"It's not like Medicaid is providing some kind of alternative lifestyle that's attractive and keeps people out of the workforce", he said.

Medicaid was historically a benefit that went hand-in-hand with welfare for the disabled and low-income single mothers and their children.

The state's request is still pending with federal Medicaid regulators, but the Trump Administration's announcement indicates such a request would be approved. That's because children - who make up almost half of Medicaid enrollees - are excluded.

The successive expansions have turned the program into the largest source of health insurance for Americans.

Medicaid now covers one in five Americans - about 73.5 million Americans. About 39 percent of them are children, and another 23 percent are blind or disabled.

"Our policy guidance was in response to states that asked us for the flexibility they need to improve their programs and to help people in achieving greater well-being and self-sufficiency", she said.

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