Kentucky First to Set Medicaid Work Requirements

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The new Centers for Medicare & Medicaid Services, which allows states to seek federal permission to establish restrictions, could threaten the Medicaid coverage of the many adults with disabilities, children and the elderly who cannot work.

Bevin noted in a news conference Friday that Kentucky's is the first waiver with a community engagement requirement approved.

But Bevin dismissed such comments and said the plan will transform Medicaid. "Overall, CMS believes that Kentucky HEALTH [Helping to Engage and Achieve Long Term Health] has been created to empower individuals to improve their health and well-being". But Rosenbaum notes the absurdity of arguing that keeping people from health care will make them more likely to be able to work.

Studies have shown that access to Medicaid makes it easier for people to look for work and maintain employment. It is the first state to win such approval. But many of those would drop out not because of finding work but because they can't overcome the new bureaucratic hurdles, say advocates for the poor. People working 120 hours a month are also exempt. Pregnant women and children will be exempt from that cost sharing.

The revisions would cut dental and vision coverage for many adults, although they can regain it by completing health-related activities, such as taking a disease management class or volunteering. Others were looking for work. Enrollees will have to show proof of these hours. "They also are a very bad policy for making sure people get health care".

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Adding a work requirement to Medicaid would mark one of the biggest changes to the program since its inception in 1966. If enrollees don't submit that information and the state finds out, enrollees will be locked out of coverage for six months.

Such "community engagement" requirements have never been approved before by CMS.

There have been questions from advocates about what "medically-frail" will mean, and how people will get that designation. The difference this time around is that the federal government will recognize it.

The Trump administration announced Thursday it will allow states to require some Medicaid recipients to work.

About 480,000 Kentuckians were added to Medicaid after the program was expanded under the Affordable Care Act, also known as Obamacare, to include anyone up to 138% of the federal poverty level, an annual income of $16,643 for an individual. "They'll be able to fill out a document to say, 'I encounter these things, whatever the diagnosis may be'".

The new rule, to be rolled out in July, would mandate able-bodied Kentuckians on Medicaid to work or volunteer 20 hours per week. Medicaid expansion is exactly that type of policy.

The state estimates about 30 percent of current recipients would have to comply. The federal government, meanwhile, would save $121.7 million in that year. During the campaign, Bevin pledged to end Kentucky's highly successful Medicaid expansion, but as governor, he did not have the courage to do it. Make no mistake: people will die because of this. Either you value life or you don't. "We will be working to ensure that it does not".

"No matter how it's packaged, Kentucky HEALTH is not about giving Kentuckians back their dignity - because they already have that".

The National Health Law Program's Legal Director Jane Perkins said litigation is expected because the approval violates federal law.

Verma, who worked with Kentucky and IN on their work requirement waivers as a health consultant before joining the Trump administration, recused herself from the decision on those states' waiver requests. For example, the federal law only authorizes the secretary to allow states to ignore Medicaid's consumer protections when a state is implementing an experimental project created to promote the objectives of the Medicaid Act.

"There's absolutely nothing that requires the exemption of people with addiction", Rosenbaum said.

In sum, the Trump administration is targeting a poor population that's not exactly slacking off, and it's trying to drive more of them to work using a strategy that hasn't exactly proven effective.

New Hampshire is one of the states seeking to employ the new program.

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