Trump work requirement rewrites health care rules for poor

WASHINGTON — Rewriting the rules on health care for the poor, the Trump administration said Thursday it will allow states to require “able-bodied” Medicaid recipients to work, a hotly debated first in the program's half-century history.

Seema Verma, head of the Centers for Medicare and Medicaid Services, said requiring work or community involvement can make a positive difference in people's lives and in their health. The goal is to help people move from public assistance into jobs that provide health insurance. “We see people moving off of Medicaid as a good outcome,” she said.

But advocates said work requirements will become one more hoop for low-income people to jump through, and many could be denied needed coverage because of technicalities and challenging new paperwork. Lawsuits are expected as individual states roll out work requirements.

“All of this on paper may sound reasonable, but if you think about the people who are affected, you can see people will fall through the cracks,” said Judy Solomon of the Center on Budget and Policy Priorities, which advocates for the poor.

Created in 1965 for families on welfare and low-income seniors, Medicaid now covers more than 70 million people, or about 1 in 5 Americans. The federalstate collaboration has become the nation's largest health insurance program.

Beneficiaries range from pregnant women and newborns to elderly

“I'm hopeful it will lead to a breakthrough,” Graham, who has forged a close relationship with Trump despite their prior political rivalry, told reporters afterward.

But in an afternoon of drama and confusing developments, three other GOP lawmakers — including two hardliners on immigration — were also in Trump's office for Thursday's meeting and said it did not produce the results Graham and Durbin were hoping for.

“There has not been a deal reached yet,” said White House spokeswoman Sarah Huckabee Sanders. But she added, “We haven't quite gotten there, but we feel like we're close.” nursing home residents. Medicaid was expanded under former President Barack Obama, with an option allowing states to cover millions more low-income adults. Many of them have jobs that don't provide health insurance.

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. with a new restriction on when the FBI can dig into the communications of Americans swept up in foreign surveillance.

During a hectic morning of House votes and presidential tweets, Trump's national intelligence director also issued new guidance for how officials can find out the names of Americans whose identities are blacked out in classified intelligence reports.

Trump has said previous rules were far too lax and led to damaging leaks about top aides, a claim fiercely contested by Democrats.

The new guidelines on “unmasking” Americans, however, were a side show to the House showdown over the Foreign Intelligence Surveillance Act, reauthorizing a collection program set to expire on Jan. 19. The bill passed 256-164 and is now headed to the Senate. It would extend for six years the program, which includes massive monitoring of international communications.