Trump administration allows states to make Medicaid recipients work

People wait in line to enter the Google booth at CES International Wednesday Jan. 10 2018 in Las Vegas.
        The Associated Press

For instance, the guidance notes that some Medicaid recipients may have trouble meeting these requirements because of poor health, substance abuse or high unemployment in their areas.

Announcement of the new guidance delivers on the commitment made by Administrator Verma in her address to state Medicaid directors last November, to "turn the page" in the Medicaid program and give states more freedom to design innovative programs that achieve positive results for the people they serve and to remove bureaucratic barriers that block states from achieving this goal.

The policy change would mark the first time the publicly funded program, which has insured the health needs of the poor and disabled since its creation in the 1960s, has been allowed to require work for benefits.

But it's not clear how many people would be affected by the new rules.

For instance, Kentucky past year proposed work requirements for able-bodied adults to get Medicaid insurance as well as new fees for all members based on income.

Seema Verma, administrator of the Centers for Medicare and Medicaid Services, speaks during a news conference in Newark, N.J. The Trump administration says it's offering a path for states that want to seek work requirements for Medicaid recipients.

Medicaid now covers one in five Americans - about 73.5 million Americans. "There is a real risk of eligible people losing coverage due to their inability to navigate this process or miscommunication or other breakdowns in the administrative process", Musumeci said. Most who are not report reasons such as illness, caring for a family member or attending college. The guidance also includes caregiving as one of the activities.

The administration is nonetheless expected to quickly approve requests from as many as 10 states, all but one of which has a Republican governor.

Health Highlights: Jan. 11, 2018
States can require Medicaid recipients to work for benefits under new Trump policy

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. But about 600,000 people in the state are covered by the program, which has seen significant changes over the past year as management was turned over to private managed care companies.

The Health and Human Services Department outlined how states could reshape the program in a directive.

Noam N. Levey is a Los Angeles Times writer.

But Mary Mayhew, a former Maine DHHS commissioner who spearheaded a number of reforms to the state's public assistance programs under LePage, said in a statement that the waiver will help Maine prioritize its neediest populations.

Verma does not specifically state that those who don't work will be cut off from Medicaid coverage, but Twitter Thursday lit up with accusations of cutting off "frail" enrollees while others applauded the initiative to get people "on the dole" back to work. Demonstrations, which give states additional flexibility to design and improve their programs, are also created to evaluate state-specific policy approaches and better serve Medicaid populations. The broadening of Medicaid to low-income adults under Obamacare - roughly 11 million have gained coverage under the health reform law's Medicaid expansion provision - further spurred GOP efforts.

"There are a lot of different ideas, and a lot of ways to go about this", Verma said.

Verma also had a major role in designing an unorthodox approach to Medicaid in IN, which had asked the Obama administration to approve a work requirement. South Dakota's governor said in his State of the State address Tuesday that he would also look to require certain recipients to work. He said they also assist people to gain the skills necessary for long-term independence and success.

A study from the non-partisan Kaiser Family Foundation found that nearly 60% of working-age adults on Medicaid are already employed. 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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