Experts Side-Eye New Green Light On Medicaid Work Requirement

Experts Side-Eye New Green Light On Medicaid Work Requirement

While Seema Verma, head of the Centers for Medicare and Medicaid Services, euphemistically described the new guidance as an effort to "transform Medicaid", analysts argued that the policy shift is little more than a "sneak attack" on an extremely popular program that provides crucial medical coverage to over 70 million Americans.

These individuals still struggle to work due to their health issues, but many will not be allowed an exemption under the new Medicaid requirements.

Along with the Trump administration's announcement, the Centers for Medicare and Medicaid Services released a guidance that outlines states' roles in implementing the change. She told reporters in a call Thursday that it could lead to a decline in Medicaid enrollment. Many of these recipients are individuals who are employed but whose jobs do not provide health insurance.

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Federal law states what an American has to do to qualify for Medicaid, he said. States must propose such changes through waivers and receive federal approval.

Many other states, such as California, are not expected to impose work requirements.

Now 10 states have submitted 1115 demonstrations with work requirements which Arizona, Arkansas, Indiana, Kansas, Kentucky, Maine, New Hampshire, North Carolina, Utah and Wisconsin. Officials in several other states have said they are interested in the idea.

The debate about work requirements doesn't break neatly along liberal-conservative lines.

CMS suggested that states developing Medicaid work requirements should consider programming that assists demographic areas with high unemployment rates and address caregiving for young children or elderly family members. Thats because children — who make up almost half of Medicaid enrollees — are excluded.

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If any eligible recipient is denied based on the new work criteria, it's likely there would be a swift challenge in the courts.

Just over one-fifth of Medicaid enrollees who hold part-time jobs cited economic factors, such as the inability to find full-time positions and weak business conditions, as the reason they aren't working more. "AHCCS isn't created to track people's work status and it's going to cost a lot of money to overhaul the system to ramp up this work requirement".

"For those who can not find work, requiring unpaid volunteer work in exchange for health coverage is unconscionable legally and morally, recalling the days of workhouses for the poor", Eliot Fishman, senior director of health policy of Families USA, a consumer advocacy group, said in a statement.

But adding work requirement to Medicaid eligibility is strongly opposed by patient advocacy groups and a number of policy analysts. Medicaid is a fundamental avenue for health care for numerous nation's poor.

But work requirements have strong public backing.

A poll a year ago from the nonpartisan Kaiser Family Foundation found that 70 percent of the public supported allowing states to require Medicaid recipients to work, even as most Americans opposed deep Medicaid cuts sought by congressional Republicans and the Trump administration. The Trump administration has stuck to its guns on opposing entitlement reform, and Republicans don't have anywhere near enough votes in the Senate to make a go of it anyway. Kentucky, whose waiver request included some of the strictest proposals, predicted they would cover 15 percent fewer adults through Medicaid after five years.

Ten states - Arizona, Arkansas, Indiana, Kansas, Kentucky, Maine, New Hampshire, North Carolina, Utah and Wisconsin - have already filed applications with CMS to add work requirements to their Medicaid programs.

Seema Verma, head of the Centers for Medicare and Medicaid Services, issued new guidance meant to help states design programs encouraging "able-bodied, working-age Medicaid beneficiaries" to participate in skills training, education, job search, volunteering or care giving.

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