Kentucky becomes 1st state approved for Medicaid work requirements

Some states will impose work requirements for Medicaid

Medicaid work requirement unlikely in Florida

"Instead, this is an effort to transform Medicaid into a work program for low-income adults with healthcare as the prize". Many of them have jobs that don't provide health insurance. The approved Kentucky waiver also. They will have to figure out how to define the work requirement and alternative options, such as going to school or volunteering in some organizations; how to enforce the new rules; how to pay for new administrative costs; and how to handle the millions of enrollees likely to seek exemptions. One of those states was Arkansas.

Adding a work requirement to Medicaid would mark one of the biggest changes to the program since its inception in 1966.

The legislature passed a law in 2017 stating that the program will not be renewed this time around, unless a work requirement is authorized. "Those days are over". The difference this time around is that the federal government will recognize it. Bevin originally submitted the waiver request to the CMS in August 2016.

Kentucky is the first state to be allowed to impose work requirements in its Medicaid program, a change that Gov. Matt Bevin has pushed.

The requirement, modeled after the work requirement for the state's food stamps program, would initially apply to enrollees ages 30-49 and would then be extended to those ages 19-29. Or, as he said on Friday, the waiver will give enrollees "the dignity associated with being able to earn the things they are receiving". He has said it will inject more personal responsibility into the government health plan and he believes participants should have some "skin in the game".

Why can't the US provide both a cost-effective safety net for health care and opportunities for people to find meaningful work?

For the current study, researchers examined data from nationwide surveys of pediatricians done by the American Academy of Pediatrics that assessed how many doctors accepted Medicaid and what proportion of patients were insured by the program.

At least nine additional states, which are predominantly led by Republican governors, have also proposed similar changes to the federal health care program in their own states.

The program will be phased in starting in July, officials said Friday.

"CMS recognizes that a broad range of social, economic, and behavioral factors can have a major impact on an individual's health and wellness, and a growing body of evidence suggests that targeting certain health determinants, including productive work and community engagement, may improve health outcomes", read the letter from Brian Neale, CMS' Medicaid director. The activities include jobs training, community service or education.

"It is critical that key decisions regarding eligibility, coverage, benefits, delivery system reforms, federal Medicaid spending, and other important aspects of these demonstrations are transparent, accountable, and in line with congressional intent", wrote Rep.

There have been questions from advocates about what "medically-frail" will mean, and how people will get that designation.

"The U.S. Department of Health and Human Services' (HHS) approval is problematic for several reasons".

This Kaiser Health News story can be republished for free (details).

But advocacy groups disagreed, including Kentucky Voices for Health, a coalition of health organizations that had opposed the changes as unnecessary and harmful to low-income people who rely on Medicaid for health care.

The National Association of Medicaid Directors, a nonpartisan group representing state officials, said in a statement that there's no consensus on whether work requirements are the right approach. "If you look at our Medicaid population, mostly children, mostly seniors, and single pregnant moms, I don't think that is necessarily something that we would do".

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