Trump administration decides states can require people to work for Medicaid

Trump administration decides states can require people to work for Medicaid

For the first time, states will be allowed to move toward requiring some Medicaid recipients to work to receive benefits, under new guidelines issued by President Donald Trump's administration Thursday.

The Trump administration is paving the way for states to impose work requirements for Medicaid recipients. On the day in March when she was sworn in as administrator of the Centers for Medicare and Medicaid Services, Seema Verma dispatched a letter to governors encouraging "innovations that build on the human dignity that comes with training, employment and independence".

Kaiser polling a year ago found that 70 percent of the public support allowing states to impose work requirements on Medicaid recipients, even as most people in the US were against deep Medicaid cuts sought by congressional Republicans and the Trump administration.

"Under the rules, states can require Medicaid beneficiaries to work, volunteer or participate in job training", reports NPR.

The elderly, disabled, children and pregnant women would be excluded from the requirements.

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.

Ten states are at present applying to force work necessities in Medicaid. The plan comes after months of failed negotiations on Capitol Hill to repeal and replace former President Barack Obama's landmark health care legislation. Many of them have jobs that don't provide health insurance.

At least 10 states, led by Republicans, were awaiting federal permission to enforce the new work rules, according to the Washington Post.

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The shift under Trump could draw legal challenges from health care, rights or seniors' groups.

"The new [state programs] will penalize individuals by having them lose health coverage, rather than incentivize them, as a voluntary program with adequately funded supportive services necessary to overcome barriers, would", she said. 30% said they were watching over a relative, while 15 percent said they would school. Aligning requirements across these programs may streamline eligibility and reduce the burden on both states and beneficiaries and help beneficiaries succeed in meeting their work and community engagement responsibilities. Most of those who don't work cite illness, disability or family obligations as the reason.

The guidance represents a fundamental and much-disputed recalibration of the compact between the government and poor Americans for whom Medicaid coverage provides a crucial pathway to health care. 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.

Thursday's administration guidance spells out safeguards that states should consider in seeking work requirements.

Conservatives have long argued that social programs can be a disincentive to work and favor making safety net benefits contingent on working.

"For the future of our country, we need all Americans to be active participants in their communities", she said in November.

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". He dismissed the agency's justification that unemployment makes people less healthy.

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