Trump's gift to GOP governors: States can now impose Medicaid work requirements

Frederick Owens
January 12, 2018

Medicaid, the joint federal-state program that provides low-priced health care, is the largest federal health program with over 70 million participants and has an annual federal budget of over $400 billion.

Sixty percent of Medicaid's non-elderly adults already work, according to a recent analysis of census data by the Kaiser Family Foundation. Another 12 percent were students, homemakers or retirees. To achieve the objectives of Medicaid, state programs should be created to promote better physical and mental health.

A full summary of the findings is available here. States must propose such changes through waivers and receive federal approval. States should take these issues - as well as recipients' employability - into consideration and allow for modifications or exemptions, the agency said.

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. "And so the net effect of this policy isn't going to be to get more people to get jobs, it is for more people not to have health care, they are going to get sicker and have less ability to get jobs". In the end, that state included in its Medicaid expansion only an encouragement of voluntary efforts by beneficiaries to train for work or find jobs.

The Obama Administration had previously rebuffed proposals allowing states the right to impose work requirements on Medicaid recipients, arguing it would result in fewer people having access to health insurance. "A study examining Michigan's Medicaid expansion found that almost seven in 10 enrollees who were working said they performed better at work once they got Medicaid coverage".

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.

Trump's gift to GOP governors: States can now impose Medicaid work requirements

Certain Medicaid recipients would be exempt from the rules, including those with disabilities, the elderly, children and pregnant women, the administration said.

Currently, 64 percent of the 100,000 non-elderly, non-disabled adults who receive Medicaid in ME are employed, according to the Kaiser Family Foundation. The vast majority of those who aren't working have an illness or disability, are caring for a family member, or are in school.

Medicaid covers about half of the babies born in this country, she said. Bullard said she has epilepsy and other medical conditions that make working long hours impossible.

"Most people have something to contribute to their community through either work or volunteering, and people who can contribute should do so", LePage said. IN rewrote its waiver request last summer, this time asking for federal permission to compel work activities.

Plus, state Medicaid agencies won't get any additional federal funding to help recipients find and hold jobs, even though they are generally not equipped to develop, provide, and administer work support programs, said MaryBeth Musumeci, associate director of Kaiser's Program on Medicaid and the Uninsured. 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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