Trump Administration Clears Way To Require Work For Some Medicaid Enrollees

13 Enero, 2018, 05:03 | Author: Earnest Bishop
  • Illinois Reviewing Medicaid Work Rule

On Friday, Kentucky became the first state with federal approval to implement a so-called work requirement for Medicaid recipients.

Opponents say the change will prevent people from getting the health care they deserve.

"By lessening dependence on government assistance and promoting individual self-sufficiency, Kentucky's efforts should also help to promote the fiscal sustainability of the program to better protect services for the Commonwealth's most vulnerable", Demetrios Kouzoukas, principal deputy administrator of the Centers for Medicare & Medicaid Services, wrote in his Kentucky approval letter. "Our fundamental goal is to make a positive and lasting difference in the health and wellness of our beneficiaries".

Maine DHHS proposes requiring that low-income, non-disabled adults work or participate in training 20 hours a week, volunteer 24 hours a month, or enroll at least half-time as a student in order to receive health coverage through Medicaid. It is likely to prompt a lawsuit from patient advocacy groups, which claim the requirement is inconsistent with Medicaid's objectives and would require an act of Congress.

Republicans have been pushing for the change since the Affordable Care Act added millions of so called "able-bodied" adults to Medicaid. This is a bit ironic because those welfare work requirements were loosened by President Obama, to the vocal dismay of his opponents.

The Trump administration is inviting states to impose work requirements on people who depend on Medicaid to pay for their health care. Officials in several other states have said they are interested in the idea.

People who gained coverage through Medicaid expansion (who can make up to $16,670 for a one-person family) will have to pay a copay or premium. Why Is Their Governor Resisting?

Bevin noted in a news conference Friday that Kentucky's is the first waiver with a community engagement requirement approved.

10 states have applied for waivers involving work requirements or community involvement for Medicaid recipients
Medicaid in Pennsylvania: the facts

If proponents of work requirements are serious about helping people find work, they would invest in skill training and workforce development programs, rather than increasing red tape and making it harder for people to access health care.

Kentucky, which has some of the poorest counties in the country, has seen its Medicaid enrollment double in the past three years after the state expanded eligibility under the ACA.

Many people insured through Medicaid are working low-income jobs with unpredictable and irregular hours. More than 60 percent of the non-working Medicaid recipients were women, according to Kaiser; 17 percent were parents with children under age 6.

More than 4 in 10 adults with Medicaid coverage already work full time, and most others either go to school, take care of a relative or are too sick to work.

Those who don't comply would be suspended from receiving health care benefits until they meet their required hours for a month.

The Maine Department of Health and Human Services past year sought federal Medicaid officials' permission to require non-disabled, low-income adults enrolled in Medicaid to work as a condition of receiving coverage.

In sum, the Trump administration is targeting a poor population that's not exactly slacking off, and it's trying to drive more of them to work using a strategy that hasn't exactly proven effective.

"It places their insurance coverage at existential risk, despite the fact that there is no evidence that suggests that work requirements produce major changes in employment or income, and despite the fact that the health risks that these kinds of requirements potentially create vastly outweigh whatever gains are going to be achieved", she said. As stressed by the administration: "To achieve the objectives of Medicaid, state programs should be created to promote better physical and mental health".

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