CMS allows states to enact work requirements for Medicaid

01/11/2018 02:21 PM

A major shift from the Trump administration will likely clear the way for a controversial requirement in Medicaid delivery.

The Centers for Medicare and Medicaid Services issued guidance to states on Thursday allowing them to compel people to work or prepare to join the workforce in order to receive Medicaid.

Kentucky’s 1115 waiver, known as Kentucky HEALTH, contains such a work requirement — and the administration is expected to soon approve the waiver, according to testimony from the Cabinet for Health and Family Services. It’s estimated the waiver would save the state $338 million over five years in running the Medicaid program, which is financed jointly by the federal and state government.

The U.S. Department for Health and Human Services rejected waivers similar to Kentucky’s under the Obama administration, as states sought to charge premiums for those earning less than 100 percent of the federal poverty level and implementing work requirements for able-bodied recipients.

Kentucky Medicaid Commission Stephen Miller, said the cabinet was excited about the rule change.

“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 in a statement. “This guidance is a critical step to moving the Kentucky HEALTH program forward and we eagerly anticipate a quick approval of our 1115 waiver. With the approval, we will continue to partner with CMS on taking a holistic approach to helping Medicaid beneficiaries improve their social, educational, and health outcomes.”

Download the CMS guidance letter here. community engagement smdl.pdf

Ninety-five percent of Kentucky has health insurance thanks to the Medicaid expansion under former Gov. Steve Beshear, D-Kentucky.

On Thursday, U.S. Rep. John Yarmuth, D-Louisville, decried the change by the CMS, saying the change would jeopardize the health care of many Americans.

“The majority of individuals enrolled in Medicaid are the elderly, people with disabilities, children, students, and working families struggling to get ahead,” Yarmuth said in a statement. “Many others are family members caring for a sick or elderly parent, grandparent, or other family member. Those remaining are largely enrollees who are too sick to work, but do not meet the strict requirements to qualify as disabled or medically frail. They will now have nowhere to turn for health care at all. The fact remains that work requirements do not make it more likely low-income individuals will find employment, but they will result in struggling families becoming poorer and sicker.”

Yarmuth continued saying, that under Kentucky’s waiver the Commonwealth would be the poster child for the “dangerous policy.”

“It is now expected that Governor Bevin’s misguided Medicaid waiver request, which includes work requirements, will be approved by the Trump Administration,” he said. “This will be the first waiver of its kind approved in the country, and—by the Governor’s own admission—will take life-saving health care coverage away from more than 90,000 Kentuckians. My only hope is that the chaos caused by this policy and the desperation of the Kentucky families who will soon lose their only access to health coverage will force Governor Bevin to demonstrate some level of compassion and reverse this disgraceful policy.”


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