Los Angeles Times

Medicaid patients in Kentucky now required to work

- By Noam N. Levey noam.levey@latimes.com

WASHINGTON — The Trump administra­tion gave Kentucky permission Friday to impose work requiremen­ts on its Medicaid recipients, making the state the first in the nation to implement the administra­tion’s new policy of allowing states to make Medicaid coverage contingent on work.

The move — which came just a day after administra­tion officials announced the new guidance — is widely expected to pave the way for several other states, almost all with Republican government­s, to incorporat­e work mandates into their Medicaid plans.

And it is likely to make Kentucky, once a trailblaze­r in implementi­ng the Affordable Care Act, into a legal battlegrou­nd over the conservati­ve efforts to reshape the half-century-old Medicaid safety-net program.

Kentucky will require working-age adults who are not disabled or acutely ill to work a minimum number of hours each week or participat­e in other “community engagement” activities, such as seeking work, going to school or volunteeri­ng.

Those who don’t meet the requiremen­ts or don’t provide adequate documentat­ion will lose coverage.

The state projects significan­t cost reductions, largely because growing numbers of poor Kentuckian­s will be caught up in the complex reporting requiremen­ts and paperwork, causing them to lose coverage.

Federal officials said in approving Kentucky’s proposal that the change would “promote Medicaid’s objective of improving beneficiar­y health” and “provide incentives for responsibl­e decision-making.”

The state will also be able to charge Medicaid recipients premiums for their coverage.

Kentucky has seen some of the biggest gains in coverage since full implementa­tion of the healthcare law, often called Obamacare, began in 2014. The state’s uninsured rate fell by more than half, making it a poster child for the law under the Obama administra­tion.

The coverage gains have also driven major increases in the share of poor state residents getting recommende­d medical care and a decline in the number who are putting off care.

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