Trump Administration Will Let States Require People To Work For Medicaid

Health and Human Services Secretary Marylou Sudders speaks during a news conference announcing more reforms to combat the opioid crisis at the State House Tuesday

Health and Human Services Secretary Marylou Sudders speaks during a news conference announcing more reforms to combat the opioid crisis at the State House Tuesday

But she said a work requirement hasn't been on her radar "because I've been completely focused on restructuring the Medicaid program and making it sustainable for MA". If they're not already working at least 20 hours a week or going to school, recipients would be required to participate in the Gateway to Work program. "Our fundamental goal is to make a positive and lasting difference in the health and wellness of our beneficiaries, and today's announcement is a step in that direction", CMS Administrator Seema Verma said. "While high-quality health care is important for an individual's health and well-being, there are many other determinants of health".

But work requirements have strong public backing.

She cited studies that show a correlation between good health and having a job. Certainly, that may be the case for some recipients, but for others who truly are down on their luck, the program provides a much-needed relief. The requirement would not apply to some participants, including pregnant women, those being treated for substance abuse, "the medically frail" and those older than 60. States should take these issues - as well as recipients' employability - into consideration and allow for modifications or exemptions, the agency said. That could mean counting time spent in drug treatment as a form of "community engagement". However, they will not be allowed to use federal Medicaid funding to finance these services. The federal-state collaboration has become the nation's largest health insurance program.

Ten states - Arizona, Arkansas, Indiana, Kansas, Kentucky, Maine, New Hampshire, North Carolina, Utah and Wisconsin - have already filed applications with CMS to add work requirements to their Medicaid programs.

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Republicans have long wanted to add work requirements to the Medicaid program, which covers almost 75 million low-income children, adults, elderly and disabled Americans.

Health insurance reforms initiated during Barack Obama's presidency raised the income cap for access to Medicaid, allowing millions of low-income earners to join the Medicaid rolls.

State legislative efforts to try to enact Medicaid work requirements have been unable to gain traction. Sen. Some Medicaid recipients say the coverage has enabled them to get healthy enough to return to work.

But it's not clear how many people would be affected by the new rules. "This is about helping those individuals rise out of poverty".

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The guidance release Thursday pointed to several studies that said unemployment is harmful to one's health and can prompt higher rates of hospital admission and death, as well as poorer general and mental health. The state estimates about one-fourth - or about 33,000 - of those referred to Gateway to Work will choose not to participate.

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. Now, she is in a position to approve them. "We continue to want people to have healthcare coverage".

The range of community engagement requirements can be quite broad, according to the CMS guidelines sent to states on Thursday. "Those days are over". According to government statistics, 60 percent of non-disabled, working-age adults having a job, while almost 80 percent live with families that have at least one member in the labor force. Most who are not report reasons such as illness, caring for a family member or attending college.

The health coverage was originally created for people with medical issues who could not physically hold jobs, and the new update will not change for those who fit into that category. They could find it difficult to apply for exempt status and verify it, which may need to be done monthly in some states, while those who are working may have a hard time verifying their hours, especially if they have variable shifts.

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On the day in March when she was sworn in as administrator of the Centers for Medicare and Medicaid Services, Seema Verma dispatched a letter to governors encouraging "innovations that build on the human dignity that comes with training, employment and independence".

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