Experts Side-Eye New Green Light On Medicaid Work Requirement

Centers for Medicare and Medicaid Services administrator during her Senate Finance Committee confirmation hearing in Washington on Feb. 16 2017. MUST CREDIT Bloomberg

The Centers for Medicare and Medicaid Services have issued new guidances to allow for individual states like ME to implement their own work requirements in order for working-age, non-disabled individuals to receive government subsidies through Medicaid.

“This new guidance paves the way for states to demonstrate how their ideas will improve the health of Medicaid beneficiaries, as well as potentially improve their economic well-being, ” Brian Neale, CMS deputy administrator and director for the Center for Medicaid and CHIP Services, said in the press release.

Sovereign Hager, an attorney with the New Mexico Center on Law and Poverty, said that the waiver New Mexico recently sent to the federal government does not include any provisions for work requirements.

This would be the first time in the 52-year history of the Medicaid program that there is any sort of work requirement. They are among the states awaiting word from CMS on their requests to impose work requirements - efforts that were routinely rejected under the Obama administration when states broached them before.

Currently, Medicaid recipients are not required to work or be employed to receive benefits.

To justify the change, the CMS letter cited studies showing a higher income correlated to a longer lifespan and that unemployment is "generally harmful to health", with those out of work showing higher hospital admission and mortality rates.

The policy change would mark the first time the publicly funded program, which has insured the health needs of the poor and disabled since its creation in the 1960s, has been allowed to require work for benefits. In fact, "a$3 mong the adult Medicaid enrollees who were not working, most report major impediments to their ability to work including illness or disability or care-giving responsibilities", according to the independent Kaiser Family Foundation.

Homeless people, former foster children and American Indians are among individuals who would be exempt from Arizona's proposed Medicaid work requirements, the state's application says.

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Pallone said that "the Trump administration's action today is cruel and a clear violation of both the Medicaid statute and longstanding congressional intent" for waivers that were meant to "allow states to expand access to Medicaid, not restrict it". They also hearken back to the program's original intent, he added, "as temporary assistance to try to help people get back on their feet, not a permanent subsidy for someone's lifestyle, if they're capable of working". They argue that new restrictions and reporting requirements will cause many people to lose Medicaid health coverage. "We know from studies that this kind of requirement doesn't work; it doesn't help people get jobs".

Under the guidance, community engagement activities would include skills training, education, job searching, volunteering or caregiving.

But rather than forcing more Americans to work for their health insurance, the move-a far-right Republican goal-will either have limited reach, or push people off of Medicaid entirely. A spokeswoman for the state health and human services office said the number of working MassHealth recipients was not available. As the Kaiser Family Foundation notes, very few state agencies now have the capacity to develop and provide work support programs on their own.

Despite increased scrutiny and regulation, the rolls have expanded yet Medicaid is not doing its job to care for vulnerable populations, she said.

People with a disability, pregnant women, elderly people, children, and the "medically frail" must also be exempted from the requirement, according to the new rule.

Also protected would be Medicaid enrollees who are too ill to work, especially because of a drug addiction.

Meanwhile, Rosman said, the Trump administration is continuing "their ongoing war on low-income people by finding yet another reason to take away health care".

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