She denounced the Obama policy as "soft bigotry of low expectations" and said "those days are over", Kaiser News said. "Our fundamental goal is to make a positive and lasting difference in the health and wellness of our beneficiaries". It is likely to prompt a lawsuit from patient advocacy groups, which claim the requirement is inconsistent with Medicaid's objectives and would require an act of Congress. And if they haven't done any of those things by that predetermined date, they'll get kicked out of Medicaid for six months and have to reapply.
The Trump administration is inviting states to impose work requirements on people who depend on Medicaid to pay for their health care.
The approval comes after the nation's top Medicaid official, Seema Verma, in a November 7 speech to state Medicaid directors, said federal officials had chose to approve such work requirements for any state seeking them.
And, since the expansion of Medicaid under the, its benefits have been a key component in addressing the rise of substance abuse. Why Is Their Governor Resisting?
CMS Administrator Seema Verma recused herself from the Kentucky decision because she had worked with state officials on the waiver request when she was a consultant before joining the Trump administration. Gov. Matt Bevin, a Republican, first sought to add such a provision in 2016. "Instead, this is an effort to transform Medicaid into a work program for low-income adults with healthcare as the prize".
Kentucky, which has some of the poorest counties in the country, has seen its Medicaid enrollment double in the past three years after the state expanded eligibility under the ACA. The new policy allows states to make exceptions to the work rules for caregivers and students, but it doesn't require that they do so. That's because children - who make up almost half of Medicaid enrollees - are excluded. Medicaid offers a "hand up", helping people stay in the workforce by getting needed care so they can provide for themselves and their families.
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More than 4 in 10 adults with Medicaid coverage already work full time, and most others either go to school, take care of a relative or are too sick to work. The report notes that implementing the work requirements "can be error prone", resulting in some people being denied benefits they should get and others receiving benefits they're not really eligible for. The letter released Thursday by CMS authorizing work requirements contains similar language.
The state was among 11 seeking work-requirement approvals from CMS.
In sum, the Trump administration is targeting a poor population that's not exactly slacking off, and it's trying to drive more of them to work using a strategy that hasn't exactly proven effective.
Medicaid is one of the largest expenses from the state's General Fund, with $8.4 billion of almost $32 billion in state spending paying for the program.
For people in exceptionally vulnerable positions - say, someone who just lost his job after failing a drug test and can't find an available space at a substance abuse program in his area - adding another bureaucratic hurdle could make it even more hard to get back on track. The commonwealth is one of ten states, including IN, that have requested approval from the federal government for such a provision.
The National Health Law Program's Legal Director Jane Perkins said litigation is expected because the approval violates federal law. It is an editorially independent program of the Henry J. Kaiser Family Foundation which is not affiliated with Kaiser Permanente.