CMS pressed to give more time for comment on Medicaid-work changes

12 January, 2018, 03:20 | Author: Roderick Gutierrez
  • FILE- Gov. Charlie Baker listens as Health and Human Services Secretary Marylou Sudders speaks during a news conference on Tuesday

States will therefore be required to describe strategies to assist eligible individuals in meeting work and community engagement requirements and to link individuals to additional resources for job training, provided they do not use federal Medicaid funding to finance these services.

The federal Center for Medicare &Medicaid Services on Thursday released guidance to states that want Medicaid recipients to work, volunteer or take part in job training.

The major policy shift seeks to overhaul the long-standing social contract between state and federal governments and poor citizens who rely on their services.

The guidance represents a fundamental and much-disputed recalibration of the compact between the government and poor Americans for whom Medicaid coverage provides a crucial pathway to health care.

Among those who do not work, 36 percent report they are ill or disabled, 30 percent report they are taking care of an ill family member or friend, 15 percent say they are in school and 9 percent say they are retired.

According to a letter sent to state Medicaid directors by CMS Administrator Seema Verma, this move is designed "to promote better mental, physical and emotional health" and "to help individuals and families rise out of poverty and attain independence". They say the move doesn't meet the objectives of the Medicaid waiver program, and Democratic groups are expected to file lawsuits over Medicaid work requirements.

Ten states - Arizona, Arkansas, Indiana, Kansas, Kentucky, Maine, Mississippi, New Hampshire, Utah and Wisconsin, are now seeking work requirements for Medicaid recipients.

Kentucky will likely become the first state to receive a waiver, which could happen as soon as Friday, the Washington Post reported. "People moving off Medicaid is a good outcome; we hope it means they don't need the program any more".

Seema Verma, head of the Centers for Medicare and Medicaid Services, issued new guidance meant to help states design programs encouraging "able-bodied, working-age Medicaid beneficiaries" to participate in skills training, education, job search, volunteering or care giving.

It now covers a broad cross-section of people, from many newborns to elderly nursing home residents, and increasingly working adults.


A Health Affairs analysis found that if work requirements were applied to Medicaid nationwide, 11 million enrollees would be at risk of losing coverage.

CMS said in a news discharge that abilities preparing or training may have the capacity to fulfill the work prerequisites.

Certain Medicaid populations would be exempt from the rules, including those with disabilities, the elderly, children, and pregnant women.

Almost eight in 10 adults in Medicaid are already in working families, and most are working themselves, according to the Kaiser Family Foundation.

Many Medicaid recipients are employed.

The Obama Administration had previously rebuffed proposals allowing states the right to impose work requirements on Medicaid recipients, arguing it would result in fewer people having access to health insurance.

"Liberals find Medicaid work requirements repugnant because they believe that Medicaid beneficiaries want to work if they can, and that providing health coverage to people who cannot afford it is an obligation of any moral nation", Altman wrote.

Advocates for low-income people expressed dismay.

"[1115 demonstration] modifications may include counting time spent in medical treatment toward an individual's community engagement requirements or exempting individuals participating in intensive inpatient or outpatient medical treatment, as well as supporting other state efforts", CMS said.

The Obama administration would have never approved such waivers, she added.

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