Published: Sun, January 14, 2018
Sport | By Gary Shelton

Trump administration to let states adopt Medicaid work requirements

Trump administration to let states adopt Medicaid work requirements

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.

"Most people have something to contribute to their community through either work or volunteering, and people who can contribute should do so", said Governor LePage.

Republicans have long wanted to add work requirements for Medicaid recipients - which covers almost 75 million low-income children, adults and elderly and disabled Americans.

Ten states, including Wisconsin through Gov. Scott Walker, have asked for that ability. The program, funded jointly by the federal government and states, provides health coverage to low-income families and individuals, including children, parents, pregnant women, seniors, and people with disabilities.

Lead author Renuka Tipirneni, M.D., M.Sc., a U-M assistant professor of internal medicine, is available to discuss the results and how they might inform the national and state-level discussion about requirements such as those laid out by CMS. Lawsuits are expected as individual states roll out work requirements.

"This policy move does not include a single penny to job training, does not add a penny to job placement, does not add a penny to job creation", Berg remarked.

The stated objective of the new guidance is to encourage work, which the Trump administration argues is ultimately good for people's health.

"This is a shift from prior agency policy regarding work and other community engagement as a condition of Medicaid eligibility or coverage, but it is anchored in historic CMS principles that emphasize work to promote health and well-being", the guidance said. "Medicaid was designed as a healthcare program, to provide vulnerable members of our society with access to care they badly need", Jack Ende, MD, president of the American College of Physicians, said in a statement.

The order may also face legal challenges.

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Some conservatives, like the Heritage Foundation's Robert Rector, have also opposed work requirements in the past, arguing people who lose coverage will likely cost the government more via unpaid emergency room bills.

The Kaiser Family Foundation has found hat approximately 40% of non-SSI Medicaid adults are not working, and these individuals are most likely to be affected by this policy. Almost 8 in 10 are part of families where at least one person works, and 60 percent are working themselves. Its existing initiative to connect Medicaid recipients with employment services is voluntary and not enough people participate, the state's proposal said. So the legislature hired an independent vendor to do the job for them.

Neale said the design of the programs that states are proposing "look a lot like" already existing work requirements in the Temporary Assistance for Needy Families (TANF) program and the Supplemental Nutrition Assistance Program (SNAP).

House Republicans in Harrisburg are still seeking a work requirement for Medicaid, and included the concept in a package of welfare reform proposals announced last week.

Almost 20 percent of the population received Medicaid benefits in 2015, according to the United States census.

But work requirements have strong public backing.

Indiana's work requirement would be phased in for those enrolled in the Healthy Indiana Program (HIP 2.0), the state's alternative Medicaid program.

More than 1.2 million non-disabled working-age adults receive Medicaid in IL, and most do work. Advocates for low-income people say they expect Kentucky's waiver to be approved shortly.

Called AHCCS Works, it will require "able-bodied" adults between the ages of 19 and 55 who do not qualify for an exemption, to work at least 20 hours a week to become eligible for benefits.

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