Kentucky Will Require Medicaid Recipients To Work For Benefits

Kentucky has become the first state in the nation to receive federal approval to impose work requirements as a condition of Medicaid coverage.

On State’s Proposal To Impose Medicaid Work Requirements Gary Herbert, talks with NPR’s Ari Shapiro about his state’s proposal to impose a work or community engagement requirement on Medicaid recipients.

Traditionally, Medicaid covered people not able to work – the elderly, children and the disabled.

The Centers for Medicare and Medicaid Services yesterday approved what it’s calling community engagement, which opens the door for work or volunteering requirements.

While more than 74 million people are enrolled in Medicaid, only a small fraction would be affected by the work requirement. “The long-term consequences include poorer outcomes for the patients and ultimately higher health care costs for the country”.

“There’s never been a work requirement in Medicaid, it’s only been in recent years that states have raised the possibility of having one”, she said.

Imposing work requirements does none of that. The waiver also allows Kentucky to require healthy adults using the program to pay premiums. The idea was that Medicaid would only be for people who otherwise couldn’t get private health insurance or reasonably afford medical care. About 60 percent of the Medicaid recipients whom the federal government considers to be able-bodied adults are already working, according to the. In his 2012 majority opinion in NFIB v. Sebelius, U.S. Supreme Court Justice John Roberts affirmed this view, writing, “Under the Affordable Care Act, Medicaid is transformed into a program to meet the health care needs of the entire nonelderly population with income below 133 percent of the poverty level”.

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

All of that, if implemented the way the administration says it wants it to be, would be more humane than not doing those things.

In a call with reporters, state officials estimated that now, there are about 350,000 people across the commonwealth that will be impacted by the work requirements.

Copyright 2018 NPR. To see more, visit http://www.npr.org/. But nine other states are now seeking approval to implement similar requirements.

Calling it an “exciting day”, Gov. Matt Bevin on Friday said federal authorities have given Kentucky broad power to reshape its Medicaid program, making it the first state in the nation to win such approval under rules that allow states to include work requirements for some recipients. It’s up to states to define that.

In its guidance, CMS pointed to studies that show working and volunteering can contribute to better health as justification that the requirement is in keeping with Medicaid’s mission.

“It’s an answer to a problem that does not exist in this State”, added Mississippi Health Advocacy Program Executive Director Roy Mitchell. Heiner. “We look forward to welcoming eligible Kentucky HEALTH members to our Kentucky Career Centers, and helping them gain the skills necessary to fill the hundreds of thousands of good-paying jobs that are available in the Commonwealth right now”. Or that they’re exempt. And people caring for minor children could be exempted.

On the surface, work requirements for Medicaid might seem cruel or punitive.

The Obama administration didn’t reject every request for change.

The Bevin administration has estimated the work requirements likely will affect about 200,000 of the adults added through the expansion.

KODJAK: Yeah. So actually, 10 states already have applied for these waivers.

The program, called Kentucky HEALTH, was approved Friday after being designed by CMS Administrator Seema Verma when she was a consultant; she recused herself from the application. So it follows along with the guidelines that were sent out today.

Before the payment increases, Medicaid fees for primary care services for all age groups were typically 59 percent of the amount paid by Medicare, the US health program for the elderly, researchers note in Pediatrics. But there’s a bit of a chicken and egg issue. And opponents are anxious that that’s the problem.

KODJAK: Thank you, Kelly.