States want Medicaid work requirements. Can they handle them?

The CMS last week issued guidance on what standards states

must meet to impose work requirements on Medicaid enrollees.

However, the question looms: Are states administratively ready or able to implement such policies?

States will not receive any additional federal funding to carry out the programs, with the exception of money they may need to update their IT systems or evaluate the impact of work requirement waivers, CMS Administrator Seema Verma announced in a call with reporters.

Arizona, Arkansas, Indiana, Kansas, Kentucky, Maine, New Hampshire, North Carolina, Utah and Wisconsin have already applied for Section 1115 work requirement waivers, with only Kentucky getting approval thus far (See related story, p. 4).

Officials in Kansas said they were still trying to determine the operational needs to support the work requirement. These are important questions to figure out. If a state doesn’t have the ability to properly implement the new waivers, people could mistakenly lose coverage.

“We’re very concerned that this could lead to people who, by all rights, should have Medicaid coverage, being ‘churned’ off, or disenrolled for reasons having to do with paperwork rather than eligibility. This would lead to dangerous gaps in coverage,” said Meg Murray, CEO of the Association for Community-Affiliated Plans.