Medicaid work mandate debated as 10 states apply for federal waivers

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Certain adults will be required to work, get job training or perform community service in exchange for getting health coverage through Medicaid, due to a landmark change in the nation’s largest health insurance program. At least 10 states have applied to the federal government for a waiver as the seek to implement requirements for single adults who want to receive Medicaid.

As DML News reported Friday, the federal government granted the state of Kentucky approval to implement work requirements for Medicaid beneficiaries, making Kentucky the first state in the nation to receive such authorization.

On Thursday, President Donald J. Trump’s administration issued guidance to states to implement the work requirements. The intention is to ”incentivize” non-elderly, nonpregnant adult beneficiaries of Medicaid to seek employment. The administration announced that it will allow states to implement certain requirements – such as getting a job, going to school, taking a job-training course or performing community service – to continue receiving the benefits.

One case of a Medicaid recipient detailed by The Associated Press seems to strengthen the argument for transitioning working-age Medicaid recipients into the workforce.

From the AP:

To Medicaid recipients such as Thomas J. Penister of Milwaukee, it has created uncertainty about their ability to have health coverage.

He has been unemployed for the last four or five years and has received Medicaid for the past two. He sees a behavioral health specialist to deal with anxiety and said Medicaid has made a big difference in his life.

Penister, 36, said he is not yet ready to rejoin the workforce.

Wisconsin is one of the states seeking a federal waiver. The state’s governor, Scott Walker (R), said work requirements help prepare recipients to leave public assistance. As for Penister, Wisconsin’s proposed changes would exempt people diagnosed as mentally unable to work.

The changes aren’t aimed at penalizing anyone, according to Republicans who say the requirements will return Medicaid to being a stopgap until people can find work, instead of a permanent solution.

From the AP:

The program, created in 1965 for families on welfare and low-income seniors, now covers more than 70 million people, or about 1 in 5 Americans. It expanded under President Barack Obama’s health care law, with a majority of states choosing to cover millions more low-income people.

States face limits on how far they can go. The administration has said states should exempt pregnant women, the disabled and the elderly, and that they should take into account hardships for people in areas with high unemployment or for people caring for children or elderly relatives. States also have to make accommodations for people in treatment for drug and alcohol problems.

Aside from Kentucky, the other nine states requesting waivers include: Utah, Arizona, Kansas, Arkansas, Wisconsin, Indiana, North Carolina, New Hampshire and Maine.

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