Sunday, 21 January, 2018

Trump administration to let states adopt Medicaid work requirements

The Oregon Capitol The Oregon Capitol John Rosman
Conrad Doyle | 13 January, 2018, 22:46

The Trump administration wants Medicaid beneficiaries to prove they are working or participating in "community engagement activities", which like most such barriers is created to jettison people from the program.

People who are elderly or disabled, and pregnant women and children, would be excluded.

"Our policy guidance was in response to states that asked us for the flexibility they need to improve their programs and to help people in achieving greater well-being and self-sufficiency", Verma said.

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

Democrats and health advocacy groups blasted the policy and said it would make it more hard for the most vulnerable Americans to have access to healthcare services.

New guidance from the Centers for Medicare and Medicaid Services says the government will back states like IN that want to make work, or community involvement, a stipulation for eligibility.

Other groups criticizing the Trump administration's plans included Public Citizen, Families USA and the advocacy arm of the American Cancer Society.

"This is about helping people rise out of poverty", Verma said Thursday in a conference call with reporters.

The states are: Arizona, Arkansas, Indiana, Kansas, Kentucky, Maine, New Hampshire, North Carolina, Utah and Wisconsin.

And states are also required to make such accommodations for people with addiction to opioids and other substances.

But Sara Rosenbaum, a professor at George Washington University who researches Medicaid and is critical of the proposed changes, said the new guidelines were "very vague" and contained few "bright lines" that would discourage states from far-reaching proposals.

FILE PHOTO: Administrator of the Centers for Medicare and Medicaid Services Seema Verma speaks after being sworn in by U.S. Vice President Mike Pence in Washington, U.S., March 14, 2017. Republicans have repeatedly failed to repeal and replace the act, a top campaign promise of President Donald Trump. Instead, his administration has sought to weaken the program through executive orders and administrative rules.

"This action by the Trump administration goes after people who are just trying to get by", Democratic U.S. Senator Ron Wyden of OR said. "Healthcare is a right that shouldn't be contingent on the ideological agendas of politicians".

"What we find in the field is most of the people who can work are working".

The administration is nonetheless expected to quickly approve requests from as many as 10 states, all but one of which has a Republican governor.

The administration outlined the work-requirement plan in a letter to state Medicaid officials that indicates the administration's willingness to grant state requests to impose requirements on working-age, non-disabled Medicaid beneficiaries.

For instance, Kentucky previous year proposed work requirements for able-bodied adults to get Medicaid insurance as well as new fees for all members based on income. A study found the proposal would reduce the number of residents on Medicaid by almost 86,000 within five years, saving more than $330 million. "People who participate in activities that increase their education and training are more likely to find sustainable employment, have higher earnings, a better quality of life, and, studies have shown, improved health outcomes".

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