Louisiana governor considering work requirements in Medicaid

Health Highlights: Jan. 11, 2018

States will now be able to impose work requirements on able-bodied, low-income American adults to receive Medicaid benefits, the Trump administration signaled Thursday.

Republicans have long wanted to add work requirements for Medicaid recipients - which covers almost 75 million low-income children, adults and elderly and disabled Americans. People who are elderly or disabled, and pregnant women and children, would be excluded. Besides employment, it can include job training, volunteering or caring for a close relative. "Our fundamental goal is to make a positive and lasting difference in the health and wellness of our beneficiaries".

In a move that's sure to ignite the fire and fury of radical leftists, the Trump administration is encouraging states to require "able-bodied" Medicaid recipients to work in exchange for health insurance. As I talk to Medicaid recipients, they want to get off public assistance; they want to have a better life.

"This is just the latest in Trump and Republicans' relentless assault on Medicaid and the broader set of federal programs people rely on". "They want to develop programs that will help them break the chains of poverty and live up to their fullest potential". "Conservatives who favor work requirements see Medicaid coverage as another form of government welfare benefit, like cash assistance, requiring reciprocal obligations from beneficiaries, and a disincentive to work".

Officials in Arizona, Arkansas, Indiana, Kansas, Kentucky, Maine, New Hampshire, North Carolina, Utah and Wisconsin have sent proposals to the federal government, according to CMS.

Studies have shown that productive work and community engagement "may improve health outcomes", she said. Why Is Their Governor Resisting?

The first waiver under the new guidance could come as soon as Friday, the Washington Post reported citing two people with knowledge of the process. Gov. Matt Bevin, a Republican, first sought to add such a provision in 2016.

One critical issue that will affect the fallout from the Medicaid work requirements is the makeup of the Medicaid program itself, the critics say. The ACA allowed states to expand eligibility to low-income adults without children, with the federal government covering most of the cost.

Many Medicaid recipients are already employed.

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Health groups and advocates for the poor - including the National Center for Law and Economic Justice and the American Lung Association - dispute Verma's contention that the Centers Medicare and Medicaid Service has the authority to grant such requests. "The work requirement will deny care to untold numbers of Americans", Public Citizen President Robert Weissman said in a statement.

The Obama administration opposed state efforts to implement work requirements in Medicaid because it could result in fewer people having health insurance.

But congressional Democrats said the Trump administration is moving in the wrong direction.

Verma, who served as a Medicaid consultant for IN and Kentucky before joining the Trump administration, has long advocated for work requirements.

CMS said the requirements "should take into consideration areas of high unemployment or care giving for young children or elderly family members".

The state's Medicaid department is already in the process of applying for a waiver to add work requirements, which was part of the budget passed previous year.

"Medicaid needs to be more flexible so that states can best address the needs of this population", Seema Verma, the head of CMS, said in a statement.

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.

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