States urged to require work for Medicaid help
Order is shift in how care for poor is administered
The Trump administration says it will encourage states to place work requirements on Medicaid recipients, a step toward a long-standing GOP goal of overhauling the program serving low-income Americans. The order would mark a significant shift in how the health-care plan is administered.
WASHINGTON – The Trump administration said Thursday it will encourage states to place work requirements on Medicaid recipients, a first step toward a GOP goal of overhauling the program serving low-income Americans.
Seema Verma, head of the Centers for Medicare and Medicaid Services, issued guidance intended to help states design programs encouraging “ablebodied, working-age Medicaid beneficiaries” to participate in skills training, education, job search, volunteering or care giving.
The orders would mark a significant shift in how the Medicaid program — government health care for low-income people — is administered. It is likely to draw strong opposition by Democrats.
“Medicaid needs to be more flexible so that states can best address the needs of this population,” Verma said in announcing an initiative that could affect millions. “Our fundamental goal is to make a positive and lasting difference in the health and wellness of our beneficiaries.”
CMS said that in areas of high unemployment, beneficiaries could meet requirements by caring for young children or elderly family members. States would be required to come up with ways to help beneficiaries meet the requirements and to help them find job training, as long as they use non-Medicaid funds to do so.
The agency is expected to start approving state waivers promoting “community engagement activities” in coming weeks, CMS officials said.
Medicaid is a federal-state collaboration covering more than 70 million people, or about 1 in 5 Americans, making it the largest government health insurance program. President Barack Obama expanded the program by allowing states to cover millions more low-income adults.
Judy Solomon, vice president for health policy at the Center on Budget and Policy Priorities, a Democrataligned policy group, said on Twitter that the initiative provides no money “for work supports” and that history shows people who are working and those who should be exempt could lose benefits. “Don’t be fooled by all the bells and whistles,” she wrote.
People are not legally required to hold a job to be on Medicaid, but states traditionally can seek federal waivers to test new ideas for the program.
CMS says 10 states have applied for waivers involving work requirements or community involvement: Arizona, Arkansas, Indiana, Kansas, Kentucky, Maine, New Hampshire, North Carolina, Utah and Wisconsin.
The order may also face legal challenges.
Health groups and advocates for the poor — including the National Center for Law and Economic Justice and the American Lung Association — dispute Verma’s contention that the Centers for Medicare and Medicaid Service has the authority to grant such requests.
Courts have said states can’t add additional requirements for Medicaid eligibility that are not in law, the coalition wrote. Some bills offered in Congress address such changes, but haven’t yet passed.