Meidcaid recipients to get work requirements

Opponents Call to Restore Funding to Medicare Medicaid

The U.S. Centers for Medicaid and Medicare Services (CMS) announced early Thursday it will authorize "community engagement" requirements that Kentucky and a half-dozen other states are seeking to impose on some people who get health coverage through the federal-state health plan.

Meanwhile, Wisconsin and IN welcomed a letter issued Thursday by the federal Centers for Medicare and Medicaid Services announcing that the agency will support state efforts to test incentives that make participation IN work or other community engagement a requirement for continued Medicaid eligibility.

"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". It has also helped people work: Studies of Medicaid expansion in OH and MI found that the majority of beneficiaries said that getting health coverage helped them look for work or remain employed.

The new policy comes as 10 states are already lined up, waiting for federal permission to impose work requirements on able-bodied adults in the program. These workers are not slackers who refuse to work, but work in industries with poverty wages and no insurance coverage (or lack affordable coverage).

The administration's latest action spells out safeguards that states should consider to obtain federal approval for waivers imposing work requirements on "able-bodied" adults.

Some 65% of men on Medicaid are working, while 56% of women are employed. Many of these sectors often don't offer employees health insurance.

States will be required to describe strategies to assist recipients in meeting the requirements and to link them to job training resources.

Nearly 60% of working-age Medicaid recipients are in fact working full- or part-time jobs, according to a Kaiser Family Foundation study.

The Trump administration and CMS claim that pregnant women, the disabled and the medically frail would be exempt from the work requirements.

LaDonna Pavetti, a vice president at the left-leaning Center on Budget and Policy Priorities, argues that none of the studies CMS' cites suggest that work requirements improve public health. The state has one of the highest rates of overdose deaths in the country, and its Medicaid spending on prescriptions for opioid use disorders jumped 326 percent from 2011 to 2016, to $64 million.

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

A Kaiser foundation summary of scholarly research shows that Medicaid as it is now constituted - without work requirements or premiums - helps low-income people with employment, pointing to studies that were done in OH and MI.

'Medicaid is a health program that is supposed to serve people who don't otherwise have coverage'.

In an address to Medicaid directors in November, Verma said that with Medicaid being an open-ended entitlement, the program and spending have grown. No state or federal administrator can add another requirement that is not in federal law.

Meanwhile, many of those who don't work are going to school or caring for children or other family members, and many others are ill or disabled but haven't been able to officially qualify for federal disability insurance.

CMS Administrator Seema Verma said 10 states have submitted demonstration project proposals: Arizona, Arkansas, Indiana, Kansas, Kentucky, Maine, New Hampshire, North Carolina, Utah and Wisconsin. And this, of course, is only for the benefit of sick poor people who have been insulted for decades every time they got to see a doctor and then didn't die.

Though participating in such activities would theoretically ensure their continued Medicaid benefits, Waligora worries that failure to comply with "onerous administrative requirements" could cause even those who are eligible to lose coverage.

According to a Kaiser foundation analysis in August, "Health coverage through Medicaid is an important precursor to and support for work".

Calling the new policy "unconscionable and illegal", Eliot Fishman, senior health policy director at the liberal consumer health lobby Families USA, said in a statement: "Today's announcement isn't about work". The program will be similar to requirements imposed on recipients of the Supplemental Nutrition Assistance Program (SNAP) and Temporary Assistance for Needy Families (TANF).

The CMS guidance gives states a great deal of flexibility to define their own exceptions to a work requirement, as well as what counts toward work.

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