Trump admin opens Medicaid to work requirement - and lawsuits

Centers for Medicare & Medicaid Services Administrator Seema Verma

Centers for Medicare & Medicaid Services Administrator Seema Verma

The Trump Administration moved Thursday to allow states to impose work requirements on their Medicaid programs for the first time, the latest adjustment of the nation's health-care system through administrative action after Republican efforts to repeal Obamacare failed past year.

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.

House Speaker Richard Corcoran, R-Land O' Lakes, told The News Service of Florida on Wednesday that the state's $26 billion Medicaid program is comprised mostly of children and seniors and that work requirements are more geared toward able-bodied adults who qualify for Medicaid under the Affordable Care Act, commonly called Obamacare.

The new policy guidance sent to states is meant to help them design demonstration projects that promote the objectives of the Medicaid program and are consistent with federal statutory requirements.

The Centers for Medicare and Medicaid Services issued guidance to support state efforts in requiring work or community involvement in demonstration projects such as skills training, education, job search, volunteering and caregiving.

Nearly two-thirds of Medicaid recipients nationally are children, elderly or disabled, and will be exempt from the new requirements.

In those states that receive a waiver for the work requirements, those now working will be required to provide documentation that they are working, and those who are not will be required to prove that they should be exempted.

"Imposing work requirements on Medicaid recipients is counterproductive and most likely illegal", said Cedric L. Richmond, the representative from Louisiana, adding that people on Medicaid who can work are already working.

The document details who should be excluded from the new work requirements — including children and people being treated for opioid abuse — and offers suggestions as to what counts as “work.” Besides employment, it can include job training, volunteering or caring for a close relative.

Kentucky is expected to be the first state to get permission, but IN also expects its waiver request to be approved IN the coming days.

The Medicaid program was started 52 years ago. “Programs that assist people in finding and keeping work are effective, not programs that penalize them by stopping health insurance or blocking them from getting health coverage in the first place.”. Many of them have jobs that don't provide health insurance.

Major changes could be coming for millions of Americans covered by Medicaid.

"Those are the people who need Medicaid coverage the most, because the rely on it".

Verma also had a major role in designing an unorthodox approach to Medicaid in IN, which had asked the Obama administration to approve a work requirement. Instead, the Trump administration has sought to weaken the program through executive orders and administrative rules.

"We are excited about the new guidance issued by CMS to allow states the flexibility to pursue innovative approaches to improve the health and well-being of Medicaid beneficiaries", Miller said.

"There's absolutely nothing that requires the exemption of people with addiction", Rosenbaum said. If those sound good to you, understand that they are known euphemisms for work requirements.

Most Medicaid beneficiaries who can work, do work.

"Productive work and community engagement may improve health outcomes", Brian Neale, the director of the federal Medicaid office, said Thursday in a letter to state Medicaid directors. No state or federal administrator can add another requirement that is not in federal law.

Medicaid is only available to people over 65, the disabled, and the nation's poorest people who don't get health care any other way. So are the more than 10 million people on Medicaid because they have a disability. Thirty-one states extended coverage in this way.

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". "Conservatives who favor work requirements see Medicaid coverage as another form of government welfare benefit, like cash assistance, requiring reciprocal obligations from beneficiaries, and a disincentive to work".

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