The head of the Centers for Medicare and Medicaid Services said Monday that she expects several states to implement plans that would require people who receive healthcare coverage through Medicaid to have to work.
“Once the first waivers are approved then we will see many [states] coming into line,” CMS Administrator Seema Verma said, answering questions from reporters at an event held in Atlanta by the Centers for Disease Control and Prevention.
Verma recently announced that the Trump administration would approve Medicaid waivers from states that would require people in the program to participate in what the administration is calling “community engagement” or what often is known as “work requirements.”
Under the proposal, Medicaid enrollees would be required to take classes, volunteer or work for at least 20 hours a week. The requirements generally contain exemptions for people who are disabled or pregnant and for children and older adults. The requirement would help enrollees move out of poverty, Verma said Monday.
The proposal is part of state efforts to shed Medicaid rolls. It also is a target for Republicans who say that the Medicaid program should go toward paying for care of the most vulnerable Americans, such as people who are disabled, rather than able-bodied adults.
“It’s not just about providing coverage for people who are living in poverty, but about coming up with a comprehensive strategy to help that individual move out of poverty,” Verma said.
Verma said her agency was working with states so they know how to implement the requirements, saying that she has seen interest from Medicaid directors in both blue and red states.
Obamacare was written to allow all states to expand Medicaid to anyone who makes less than $16,000 a year, regardless of other factors. A Supreme Court decision made the provision optional, leaving 19 states without expansion. Some states use Medicaid waivers to change certain parts of the program, and though the Obama administration accepted some waivers for expansion, it determined it was against the mission of the program to implement work requirements.
It’s not clear if Medicaid rolls would significantly shrink because of a work requirement. According to the Kaiser Family Foundation, which researches health policy, 59 percent of Medicaid enrollees in 2015 worked full- or part-time. Among those who did not work, 35 percent reported that they were ill or disabled, 28 percent said they were caring for a sick family member, and 18 percent said they were in school.
Polling from the Kaiser Family Foundation also shows that work requirements have the support of 70 percent of voters.
