Trump administration allows states to make Medicaid recipients work

Illinois Reviewing Medicaid Work Rule

While Carolina Cares is awaiting legislative action from the General Assembly, it should be noted that Carolina Cares has language to impose work requirements if it should be enacted. Under state work requirements, people have to verify their work status or their qualification for an exemption, according to, associate director of Kaiser Family Foundation's Program on Medicaid & the Uninsured. More than 500,000 people gained coverage under Medicaid expansion in Kentucky, which was considered a success story of the Affordable Care Act. Among those Medicaid recipients who aren't working, most reported that a major illness, disability or family caregiving responsibility prevented them from working. "It is an unconscionable attack on our state's health, and I will continue to fight for every Kentuckian to get the health care they need and deserve".

Starting in July, certain people in the state between the ages of 19 and 64 must complete 80 hours per month of "community engagement" requirements, in order to keep their Medicaid benefits. A Kaiser Family Foundation analysis a year ago found that most of the 10 million Medicaid enrolled adults had legitimate excuses for not working with only 6 percent unemployed because they could not find a job.

Thursday's administration guidance spells out safeguards that states should consider in seeking work requirements.

"And, ironically", she added, "as people lose their Medicaid coverage, it will become even more hard for them to get and hold jobs". Considering these data, it appears that states will have to deal with the administrative burden and cost of tracking adults' working status unnecessarily.

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In addition, Neale said, researchers have found "strong evidence that unemployment is generally harmful to health", while employment tends to improve "general mental health". Ironically, the program seeks to encourage Medicaid beneficiaries to pay premiums and stay enrolled continuously, "even when healthy...to increase continuity of care", according to the CMS letter; the tax plan just passed by Congress eliminates the individual mandate that required consumers at higher income levels to do the same thing. "In a state where 443,000 people benefited from Medicaid expansion since previous year, this will be devastating for the people of the Commonwealth".

HEALTH will show America how an overhaul of Medicaid can work, Bevin said.

While Bevin said that Kentucky's new program, called HEALTH (Helping to Engage and Achieve Long Term Health) would improve Kentuckians' health outcomes, critics, including U.S. Rep. John Yarmuth, D-Ky., said it would kick tens of thousands of people off health insurance. It approved a small number of conservative states' waivers, including those that require beneficiaries to pay a small monthly premium and freeze coverage when premiums aren't paid. Several other states are considering such work requirements.

ALISON KODJAK, BYLINE: Well, so they came in the form of a letter from Seema Verma, who's the head of the Center for Medicare and Medicaid Services, to the state Medicare, Medicaid directors.

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The guidance specifies only that pregnant women and "medically frail" people be exempt - though frailty is not defined - and that people with opioid addiction be either exempted or allowed to count time in drug treatment toward work activities. They also hearken back to the program's original intent, he added, "as temporary assistance to try to help people get back on their feet, not a permanent subsidy for someone's lifestyle, if they're capable of working".

One Bevin staffer suggested that the state's Medicaid rolls will be reduced by roughly 95,000 within the next five years because of the work requirements.

The waiver also would impose a six-month coverage lockout if Medicaid beneficiaries get a new job or a new salary and don't tell the state.

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