Published: Fri, January 12, 2018
Global | By Shelia Dennis

Trump White House clears path for Medicaid work requirement

Trump White House clears path for Medicaid work requirement

"This is a political move to take health care away from people", Merrill said. "We see people moving off of Medicaid as a good outcome", she said. The demonstration projects will be done by Section 1115 Medicaid waivers as under current law, states can not impose a work requirement as a condition of Medicaid eligibility. It allowed states to provide coverage to anyone earning up to 138 percent of the federal poverty level (about $16,600 for an individual).

"People who participate in activities that increase their education and training are more likely to find sustainable employment, have higher earnings [and] a better quality of life", Verma said.

Currently, about 8 in 10 non-elderly adults who are covered by Medicaid and don't qualify because of a disability live in a working household, and a majority work themselves, according to the Kaiser Family Foundation, a research organization. President Obama expanded the program by allowing states to cover millions more low-income adults.

A Kaiser foundation summary of scholarly research shows that Medicaid as it is now constituted - without work requirements or premiums - helps low-income people with employment, pointing to studies that were done in OH and MI.

As of October 2017, almost 75m individuals were enrolled in Medicaid and the children's health insurance program (Chip).

In states that decide to impose the new requirement, it is widely expected to shrink Medicaid rolls.

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LePage released a statement praising the Trump administration for giving states the ability to add the requirements. Her agency spelled out safeguards that states should put in place to get federal approval for their waivers. Aligning requirements across these programs may streamline eligibility and reduce the burden on both states and beneficiaries and help beneficiaries succeed in meeting their work and community engagement responsibilities.

Ten states have asked the agency for flexibility in the Medicaid program, according to Verma.

But work requirements have strong public backing. 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". "This is illegal. The (Trump) administration doesn't have the power to waive what isn't in the law, unless Congress were to change the law". "Healthcare is a right that shouldn't be contingent on the ideological agendas of politicians". Ron Wyden of OR, the top Democrat on the Senate committee that oversees Medicaid.

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.

Many recipients do not work because of illness (36 percent) or family obligations (30 percent), the study found.

"Most people have something to contribute to their community through either work or volunteering, and people who can contribute should do so", LePage said. The current request would require able-bodied adults without dependents to work at least 20 hours a week.

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CMS also encourages states to consider a range of activities that could satisfy work and community engagement requirements. That's because children - who make up almost half of Medicaid enrollees - are excluded.

Administrator Verma cited the Administration's firm commitment to combat our nation's opioid crisis and the letter outlines that CMS will require states to make reasonable modifications for individuals with opioid addiction and other substance use disorders. Critics say the plan violates federal law.

Federal officials say work requirements will improve the overall health of beneficiaries, leading to lowered costs for taxpayers.

"This is a very complex issue that will require thoughtful and nuanced approaches", said the group. Although waivers can have lasting impact they don't amount to a permanent change in the program. Demonstrations, which give states additional flexibility to design and improve their programs, are also created to evaluate state-specific policy approaches and better serve Medicaid populations.

"Medicaid was designed as a health care program, to provide vulnerable members of our society with access to care they badly need", said Dr. Jack Ende, president of the American College of Physicians. "That is what is best for the people of ME and the future of our state".

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