Potential major changes coming for those on Medicaid

Centers for Medicare & Medicaid Services Administrator Seema Verma

Centers for Medicare & Medicaid Services Administrator Seema Verma

Lawsuits are expected as individual states roll out work requirements.

But Sara Rosenbaum, a law professor at the Milken Institute School of Public Health at George Washington University, said the letter doesn't actually bar states from kicking people with substance abuse problems off their insurance. The guidance also includes caregiving as one of the activities. They fear many recipients will be unable to meet the mandate and be left uninsured. But the plan is likely to face strong political opposition and even legal challenges. She cited studies that show a correlation between good health and having a job. It also states explicitly that states can't get federal Medicaid money for services like childcare and transportation that people might need to get back to work.

-Taking into account hardships for people in areas with high unemployment, or for people caring for children or elderly relatives.

While Corcoran said the House won't move ahead with the idea this year, the Republican-led chamber considered it last year. They work hard to provide for themselves and their families, and would resent having to part with funds normally used for that goal to provide for someone else who just "sits on their ass". However, they can not use federal Medicaid funding to pay for those services.

The new policy guidance sent to states is meant to help them design demonstration projects that promote the objectives of the Medicaid program and are consistent with federal statutory requirements.

Medicaid is the nation's largest public insurance program, providing health benefits to almost 74 million Americans, chiefly low-income adults.

Verma, and proponents of the requirements view it differently.

It's still unclear when and if Pennsylvania will apply for the federal waiver. The guidance document suggests that state Medicaid directors should incorporate work requirements into other state programs that promote wellness, increase employment opportunities, and ultimately improve financially-based social health determinants. "This is about helping those individuals rise out of poverty".

On Thursday, the Trump administration announced new policy guidance allowing states to require people on Medicaid work or volunteer to maintain eligibility. 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. Now, she is in a position to approve them.

The National Association of Medicaid Directors, a nonpartisan group representing state officials, said in a statement there's no consensus on whether work requirements are the right approach. "Those days are over".

In Iowa, there are 600,000 Medicaid recipients, about 40 percent of whom are aged between 22 to 64, according to the latest quarterly report from the state Department of Human Services. Two-thirds of Illinois' non-disabled and non-elderly Medicaid recipients hold a full-time or part-time job, and more than 80 percent are part of working families, according to the Kaiser Family Foundation's analysis of 2016 Census data. The current request would require able-bodied adults without dependents to work at least 20 hours a week.

Overall, the guidance is being offered "to strengthen the Medicaid program to better serve our beneficiaries", Verma said. Individuals would be also be exempt if a medical professional determines they're medically frail or have an acute condition preventing them from working.

But the requirements have been controversial with health advocates who say many people on Medicaid, a plan for low income or disabled people, already work at low wage jobs that don't come with health coverage.

"Medicaid's core mission is to provide comprehensive health coverage to low-income people so they can get needed health services", Hannah Katch a senior analyst at the left-leaning Center on Budget and Policy Priorities, wrote in a blog post responding to the decision.

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