Bevin, who ran for governor in 2015 on a promise to repeal Kentucky's wildly successful Medicaid expansion, said Friday that the changes "will be transformational". Those generally include requirements for recipients to be working, be looking for work, volunteering or in school. Also off the hook are the more than 10 million enrollees who have a disability.
A bipartisan commission appointed to study the issue over the summer, led by Majority Leader Jeb Bradley, R-Wolfeboro, recommended that the program be continued but left numerous details to lawmakers - including how the state will pay for its 10 percent share of the expansion in 2020 and beyond. Oh, sure, they may have trouble finding meaningful labor, but surely there's a community engagement opportunity out there somewhere for the folks who just got the lion's share of the largesse that's expected to add $1.5 trillion or more to the national debt.
HHS and the states proposing work requirements seem to assume that anyone who finds work will have access to employer-provided insurance and, thus, will no longer need Medicaid.
But work requirements have strong public backing.
Yesterday's guidance from Verma and the CMS fulfilled that promise.
Don't be fooled by all the bells and whistles in #Medicaid work guidance.
The document says who should be excluded from the new work requirements - including children and people being treated for opioid abuse - and offers suggestions as to what counts as "work".
The goal is to increase employment among Medicaid recipients. States should take these issues - as well as recipients' employability - into consideration and allow for modifications or exemptions, the agency said. People working 120 hours a month are also exempt.
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. The activities include jobs training, community service or education. However, they will not be allowed to use federal Medicaid funding to finance these services. It approved a small number of conservative states' waivers, including those that require beneficiaries to pay a small monthly premium and freeze coverage when premiums aren't paid.
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 changes will not affect those covered by the traditional scope of Medicaid prior to the ACA: the elderly, disabled, medically frail, pregnant women or those caring for children or other family members.
"The action appears created to achieve significant cuts in Medicaid enrollment rather than Medicaid's stated objective of furnishing medical assistance to low-income people", NHeLP Legal Director Jane Perkins said. That Medicaid expansion was sharply criticized by conservatives, and Republicans in Congress tried to add work requirements in their unsuccessful bid previous year to overturn the health law. "This effort is about helping people rise out of poverty".
Dustin Pugel, policy analyst with the Kentucky Center for Economic Policy, said Friday the change will reverse "the historic progress" Kentucky made in health care over the past two years.
The Arizona Health Care Cost Containment System, or AHCCCS, the state's Medicaid program, has submitted a waiver request to implement these kinds of requirements. It is also contrary to HHS's claim that "work requirements" promote work. Providers and advocates in Kentucky immediately blasted the waiver approval.