On Jan. 11 the Trump White House released guidelines for a “community engagement initiative” that will allow states the opportunity to mandate work requirements for patients on Medicaid.
In a letter from the Centers for Medicare and Medicaid Services (CMS), Brian Neale, CMS Deputy Administrator and Director for the Center for Medicaid and CHIP Services, wrote:
“CMS, in accordance with principles supported by the Medicaid statute, has long assisted state efforts to promote work and community engagement and provide incentives to disabled beneficiaries to increase their sense of purpose, build a healthy lifestyle, and further the positive physical and mental health benefits associated with work. CMS supports state efforts to enable eligible individuals to gain and maintain employment.”
A reported 10 states have already started to pursue the establishment of a Medicaid work requirement; many expect Kentucky to become the first state to implement these requirements, which would make it the first state to do so in Medicaid’s 52-year history.
Some patients will receive exemptions from state work requirements, including children, the elderly, patients with disabilities, and some patients with opioid and other substance abuse problems.
In opposition to these efforts, Democrats see work requirements for Medicaid as a bridge too far. Said Sen. Ron Wyden (D-OR), ranking member of the Senate Finance Committee with jurisdiction over CMS, “This action by the Trump administration goes after people who are just trying to get by while taking care of their kids or elderly parents, struggling with a chronic condition, or going to school.”
Republican supporters of these measures argue that the Affordable Care Act has extended Medicaid beyond protecting the most vulnerable Americans. In support, CMS noted the positive effects that employment yields for patient health.
For a further discussion on CMS and changes in Medicaid, please contact AASM advocacy staff by phone at (630) 737-9700 or by email at firstname.lastname@example.org.