Trump Clears Path for States to Require Employment for Medicaid

Centers for Medicare & Medicaid Services Administrator Seema Verma

States wouldn't be able to request work requirements for disabled people and children under the new guidance; however, a number of nonpartisan health care think tanks point out that many Americans who rely on Medicaid can not work because they are the primary care providers for much sicker family members or live with other socioeconomic realities that make finding work more hard.

Berg said healthcare is a human right and to say you can't have it if you've only worked so many hours "is cruel, counterproductive and idiotic". CMS is blocking states from using any savings derived from cutting off people's Medicaid to achieve revenue neutrality. And most of those said they were searching for work, which is another exemption that recipients can generally use - provided it's documented.

Officials in Arizona, Arkansas, Indiana, Kansas, Kentucky, Maine, New Hampshire, North Carolina, Utah and Wisconsin have sent work requirement proposals to the federal government, according to the Centers for Medicare and Medicaid Services, which said the guidance will help states design demonstration projects.

It's also essential to recognize that Medicaid work requirements won't 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.

States are still awaiting formal approval of their requests. Opposing work requirements for able-bodied beneficiaries, she said, was "soft bigotry" on the part of the Obama administration, which hadn't approved a waiver Verma helped design in IN which originally contained such a provision.

So does candidate Paul Mango, a western Pennsylvania businessman, who said in a statement that Obamacare's Medicaid expansion - which allowed more nondisabled adults to access the program's health coverage - "is stretching the safety net for some of our most fragile populations".

Why is the Trump administration talking about a work requirement?

Kaiser polling past year found that 70 percent of the public support allowing states to impose work requirements on Medicaid recipients, even as most people in the us were against deep Medicaid cuts sought by congressional Republicans and the Trump administration. Under our proposal, people who receive Medicaid and are able bodied will need to work, be training for a new career, or volunteer. Consumer advocates and health policy experts fear that such a requirement could prove a big hurdle for many recipients, leaving them without the care they need.

These racial stereotypes are not only ugly and hateful, they also obscure the actual lived experiences of people who are covered by Medicaid. Some 60% of non-disabled, working-age adults have jobs, while almost 80% live in families with at least one member in the labor force, according to a Kaiser Family Foundation analysis.

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Soon, the administration will likely approve "waiver" proposals, starting with Kentucky and IN and followed by other states, to end Medicaid coverage not only for people who aren't working, but also for those who didn't pay premiums - or renew their coverage - on time.

Garcia believes the new guidelines will act as an impediment which will discourage some people from getting health care and in turn they will rely more on emergency room care.

But congressional Democrats and advocates said the Trump administration is moving in the wrong direction.

Among adult non-elderly Medicaid enrollees who do not work, most report major impediments to their ability to find a job, according to KFF.

Included on the extensive list of Arizonans who would be exempt from work requirements are people younger than 19 and older than 55; victims of domestic violence; individuals with serious mental illness; American Indians; people who are homeless; former foster youths up to the age of 26; pregnant women; full-time students; people recently impacted by a death or catastrophic event; and caregivers of a family member enrolled in the Arizona Long Term Care System, the application states.

The new policy would not apply to people who qualify for the program because of a disability, the memo said.

Moreover, given the bleak prospect for meaningful health care legislation at the federal level in 2018, Trump's willingness to allow states the flexibility to do their own reform is a promising development.

Thursday's administration guidance to states spells out safeguards that states should consider in seeking work requirements. These are individuals who are physically capable of being actively engaged in their communities, whether it be through working, volunteering, going to school or obtaining job training.

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