The Trump administration will approve more state requirements that require certain Medicaid beneficiaries work or train for work as a condition of staying enrolled in the program, even though a lawsuit knocked down a related provision in Kentucky and another suit is pending in Arkansas.
The intention was announced Thursday morning by Centers for Medicare and Medicaid Services Administrator Seema Verma. The remarks are the first she has made declaring how the Trump administration would proceed following the legal blockades.
“We are committed to this issue and we are moving closer to approving even more state waivers,” Verma said at the Medicaid Managed Care Summit in Washington, D.C.
At least eight other states — Arizona, Kansas, Maine, Mississippi, North Carolina, Ohio, Utah, and Wisconsin — have pending requests for similar work requirements.
Under Obamacare, states were allowed to expand government-funded Medicaid coverage to people of under specific income level, of roughly $16,000 a year, regardless of whether they are working. Medicaid otherwise covers pregnant women, people with disabilities, people in nursing homes, and children, a group that members of the Trump administration and conservatives say should remain the focus of the program.
In response to the tension, and to reduce Medicaid costs, some states have asked the Trump administration for waivers from that rule to implement “community engagement requirements,” also known as work requirements, that would obligate certain enrollees to work, take classes, or volunteer as a condition of staying on the program.
Verma acknowledged in her speech Thursday that the Medicaid requirements were controversial, but said she thought allowing people to move toward “self-sufficiency” was a more compassionate approach than “to trap people on government programs.”
“True compassion is giving people the tools necessary for self-sufficiency … allowing able-bodied, working age adults to experience the dignity of a job, of contributing to their own care, and gaining a foothold on the path to independence,” she said.
Though the provisions contain multiple exemptions for people undergoing treatment for addiction and for caregivers, among other groups, critics say people will be unable to keep up with the reporting requirements and become uninsured. They have said that the programs are an attempt to throw people off Medicaid and that tracking the work requirement is more expensive than healthcare coverage.
Responding to such arguments, Verma said, “We view these as important investments, not unlike those we have made in other aspects of the program, that help build capacity for states to address the whole human needs of their beneficiaries, and one that can pay dividends as we aim to end cycles of generational poverty.”
In Arkansas, more than 4,300 people were unenrolled from Medicaid after failing to log their hours online. State officials said some people had moved to another state or obtained a job, while others had failed to fulfill the requirement.
In her speech, Verma centered in on the 1,000 people state officials said had found jobs since the program started in July.
“Community engagement requirements are not some subversive attempt to just kick people off of Medicaid,” Verma said. “Instead, their aim is to put beneficiaries in control with the right incentives to live healthier independent lives.”
