Trump administration unveils guidelines on Medicaid work requirements

  • Trump administration unveils guidelines on Medicaid work requirements

Trump administration unveils guidelines on Medicaid work requirements

A large majority of Medicaid recipients - nearly two-thirds - are children, elderly or disabled.

"[What] really kills me about this is that the reason they used to justify a work requirement for Medicaid were things like 'statistics show that when people have more money, their life expectancy is longer and their health is better, '" Gerisch said, adding with exasperation, "Maybe that's because they can get all the health care they need without worrying about whether it will impinge on their ability to feed their families".

AHCCCS officials say the waiver request is created to provide low-income, able-bodied adults "the tools needed to gain and maintain meaningful employment, job training, and education". "We see people moving off of Medicaid as a good outcome", she said.

The Trump administration said it would allow states to test requiring some Medicaid recipients to work or participate in community activities such as volunteering or jobs training as a condition of eligibility for the government health insurance program for the poor. But as these CMS bureaucrats are well aware, as a result of these policies, increasing numbers of workers and sick people will be stripped of their health benefits and be plunged deeper into poverty. That's about 15 million people. It is likely to prompt a lawsuit from patient advocacy groups, which claim the requirement is inconsistent with Medicaids objectives and would require an act of Congress. This disagreement with expansion lies at the heart of the decision to allow states to make Medicaid changes that the states themselves admit will reduce coverage.

Sixty percent of Medicaid's non-elderly adults already work, according to a recent analysis of census data by the Kaiser Family Foundation.

Federal and state officials and health policy experts said that Medicaid beneficiaries could work at a variety of jobs - as cashiers, telemarketers, housekeepers, nursing and home health aides, child care providers, cooks and dishwashers, waiters and waitresses, retail sales clerks, landscapers, security guards and construction laborers, for example. Rep. Travis Cummings, R-Orange Park, introduced a bill that would have required all Medicaid beneficiaries who are part of the state's "managed medical assistance" program to adhere to the same work requirements that now apply to families who receive temporary cash assistance. The key point, as the Medicaid analyst Jessica Schubel points out, is that neither of those goals align with Medicaid's mission of providing comprehensive health insurance to low-income people. Just 6 percent say they want to work but can't find a job.

"This is something that they've been gunning for for a long time", she said.

Kentucky, where the uninsured rate for low-income adults plummeted under the Medicaid expansion (from almost 40% in 2013 to 7% at the end of 2016), estimates its proposed changes will cut enrollment by 15% in five years. "We know from studies that this kind of requirement doesn't work; it doesn't help people get jobs".

Trump administration unveils guidelines on Medicaid work requirements

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Wolf vetoed a budget-related bill previous year that would have required the administration to include a work-search requirement in the Medicaid program. From 2011 to 2016, Medicaid spending on prescription treatments for opioid use disorder rose from $394.2 million to $929.9 million, according to a report from the Urban Institute, a left-leaning Washington, D.C., think tank.

People who actually care about health care policy, and not about wedging the poor and frail into a character in some sort of cheap morality play, are predictably aghast.

And states must comply with federal disability rules, which means they can't deny care to people who cannot work. In 1996, President Bill Clinton signed the Personal Responsibility and Work Opportunity Reconciliation Act.

In addition, federal officials said, providing care for young children or elderly family members can sometimes qualify as work.

So does candidate Paul Mango, a western Pennsylvania businessman, who said in a statement that Obamacare's Medicaid expansion - which allowed more nondisabled adults to access the program's health coverage - "is stretching the safety net for some of our most fragile populations".

Indiana's proposal was included, which has been operating under a waiver of some federal rules.

Some 65% of men on Medicaid are working, while 56% of women are employed.