Want Medicaid? NC could now require you to work for it

Posted January 12, 2018

In a 10-page letter to state Medicaid directors, the agency issued guidance for states seeking such waivers.

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. "What she is in fact doing is promoting the hard bigotry of animus against poor people - the hard and shameful bigotry of health care denial based on wealth", Weissman concluded.

"This new guidance paves the way for states to demonstrate how their ideas will improve the health of Medicaid beneficiaries, as well as potentially improve their economic well-being", Brian Neale, CMS deputy administrator and director for the Center for Medicaid and CHIP Services, said in the press release.

KFF expressed concerns about 1115 demonstrations with work requirements because the majority of Medicaid members not working said they have a major disability, while working Medicaid members could face other administrative obstacles in receiving benefits.

Officials in Arizona, Arkansas, Indiana, Kansas, Kentucky, Maine, New Hampshire, North Carolina, Utah and Wisconsin have sent proposals to the federal government, according to CMS.

Kentucky will likely become the first state to receive a waiver, which could happen as soon as Friday, the Washington Post reported.

The Obama administration stretched the guidelines for Medicaid coverage to allow millions of working adults to qualify for the program.

"Our arrangement direction was because of states that approached us for the adaptability they have to enhance their projects and to help individuals in accomplishing more noteworthy prosperity and independence", Verma said in an announcement.

But it's not clear how many people would be affected by the new rules.

'There's never been a work requirement in Medicaid, it's only been in recent years that states have raised the possibility of having one, ' she said.

Thursday's policy change is the first to open the door to mandating work for recipients since Medicaid's introduction in 1965. 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.

Echoing Bruenig in a tweet on Wednesday, Roosevelt Institute fellow Michael Linden concluded, "There is perhaps no better example of the moral rot at the core of the Republican Party than imposing so-called "work requirements" on sick Medicaid recipients just weeks after passing a massive tax cut for rich heirs who literally did no work at all to inherit their wealth".

"It is stupid because it will actually prevent people from working - with health needs unattended, many low-income people will be unable to seek work". Thursday the Trump Administration announced it's encouraging states to add these requirements for able-bodied adults.

Some 60% of non-disabled, working-age adults have jobs, while almost 80% live in families with at least one member in the labor force, according to a Kaiser Family Foundation analysis. In 1996, a welfare reform bill passed by the Republican-controlled congress and signed by President Bill Clinton, a Democrat, added work requirements to welfare benefits, among other changes to the welfare program now known as Temporary Assistance to Needy Families.

"Don't be fooled by all the bells and whistles in #Medicaid work guidance", Vice President for Health Policy at the Center on Budget Judy Solomon wrote on Twitter. The ACA allowed states to expand eligibility to low-income adults without children, with the federal government covering most of the cost.

CMS Administrator Seema Verma touted the guidance, tweeting that "We owe beneficiaries more than a #Medicaid card; we owe them the opportunity and resources to connect with job skills, training and employment so they can rise out of poverty".