States can force 'able-bodied' to work for Medicaid, rules Trump administration


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. "Federal Medicaid laws do not permit work requirements".

Many recipients do not work because of illness (36 percent) or family obligations (30 percent), the study found. According to government statistics, 60 percent of non-disabled, working-age adults having a job, while almost 80 percent live with families that have at least one member in the labor force.

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

The new policy guidance sent to states is meant to help them design demonstration projects that promote the objectives of the Medicaid program and are consistent with federal statutory requirements. The work requirements will likely be challenged in court.

Asked whether Gov. Kim Reynolds might pursue a work requirement, a spokesperson, Brenna Smith, said Thursday that "the governor is reviewing and considering the guidelines that just came out today". She quoted from a speech President Lyndon Johnson gave a half-century ago, when he said that Medicaid's aim " is not only to relieve the symptoms of poverty but cure it".

Many Medicaid recipients are already employed. Without health insurance, individuals may forgo needed services, and their health may deteriorate to a point that interferes with their ability to work.

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The Health and Human Services Department outlined how states could reshape the program in a directive. "While high-quality health care is important for an individual's health and well-being, there are many other determinants of health".

"So I think you take those recommendations, embed it in, put it back on the Governor's desk and let him explain to taxpayers why people who are capable of working are not working", said Rep. Seth Grove, (R) - York County. "We see people moving off of Medicaid as a good outcome", she said.

CMS said the work and community engagement policy is for working-age, non-pregnant Medicaid beneficiaries who are not eligible for Medicaid on the basis of a disability. 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. 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.

Before she became the CMS administrator, Verma was a health-care consultant who specialized in helping states redesign their Medicaid programs. The guidance also includes caregiving as one of the activities. We know from experience with work requirements in Temporary Assistance for Needy Families and SNAP (formerly food stamps) that large numbers of people lost benefits because the state decided they hadn't met various paperwork requirements to show they were working or unable to work or they experienced other barriers to proving they were exempt from the requirement.

She is part of a team based at the U-M Institute for Healthcare Policy and Innovation that is evaluating Michigan's Medicaid expansion under contract with the state government.