State-Level Work Requirements For Medicaid to Be Implemented

The Trump administration will begin to allow states to implement work requirements for Medicaid. These would require able-bodied adults to work or participate in “community engagement activities” to qualify for Medicaid.[1][2]

You can see the press release by CMS here: CMS announces new policy guidance for states to test community engagement for able-bodied adults. Below is a summary of what this means and some insight.

Although states have flexibility in how and if the rules are implemented, the concept of these work requirements is that able-bodied adults can potentially meet the requirement through paid work, volunteer work, job training, searching for a job, going to school or taking care of someone elderly or disabled.

Work requirements are already used for other welfare programs such as food stamps programs in some states, but this is the first time work requirements will be implemented for Medicaid.

The move toward this isn’t a new concept. Rather, this conditional has been long sought after by Republicans, had been discussed last year, and was hinted at in the tax plan (the tax plan eluded to reforms to welfare programs like Medicaid, the general idea being that welfare reforms in 2018 will set off some of the tax cuts in the budget).

There is likely to be a lot of pushback for a myriad of complex reasons focused around the fact that some segments of the population need the care Medicaid provides, but for a range of reasons have trouble entering the jobs market.

We know we don’t have 100% employment in the country, we know we really won’t and can’t, thus strict work requirements imply that some will be left without access to care.

There are pros and cons, and with volunteer options it helps to justify the impending programs. Still, when we consider that about 70% of families on Medicaid have at least one household member who works, and when we consider that the other 30% tends to include families who are struggling and need the assistance regardless of their ability to meet the standards that states might start laying out, it at the very least paints a complex picture.

FACT: Work requirements cannot be imposed on pregnant women, the elderly, children, or those who were unable to work because of a disability. States must also create exemptions for people who are “medically frail.” See: NYTimes.com. Trump Administration Says States May Impose Work Requirements for Medicaid.

Citations

  1. NYTimes.com. Trump Administration Says States May Impose Work Requirements for Medicaid.
  2. CMS announces new policy guidance for states to test community engagement for able-bodied adults.

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