The change will allow states to craft programs that would require Medicaid recipients to prove they are working, training for a job, or volunteering in their communities, according to guidance issued by the Centers for Medicare and Medicaid Services. The office plans to take a close look at how their waiver can align with the new federal guidelines.
A 10-page letter sent to state Medicaid directors Thursday morning indicates that states would be allowed to sever Medicaid benefits for the unemployed, those not in school, and those not participating in varying forms of "community engagement", including job training, volunteer work and caregiving.
A poll from the Kaiser Family Foundation in June showed that fully 70 percent of Americans favored allowing states to impose work requirements on non-disabled adults receiving Medicaid, which is basically what the Trump administration is doing.
In those states that receive a waiver for the work requirements, those now working will be required to provide documentation that they are working, and those who are not will be required to prove that they should be exempted.
An advocacy group in ME vowed to fight the waiver, arguing that it's illegal and that the current Medicaid program supports work by giving people access to health care, making them more likely to stay well enough to be employed.
"This is creating an impediment to people who might've lost their job and in fact need help getting work, not an extra requirement that keeps them from getting the needed medical care that keeps them healthy", Wagner says.
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But the new policy is exactly what some Republican governors were seeking.
Under the 2010 Affordable Care Act, Obama's signature domestic policy achievement commonly known as Obamacare, 31 states expanded Medicaid to those making up to 138 percent of the poverty level as defined by the federal government, adding millions of people to the rolls.
This would be the first time in the 52-year history of the Medicaid program that there is any sort of work requirement.
Under federal law, Medicaid waivers have to support the program's objectives by increasing coverage or health outcomes for people on Medicaid.
The national advocacy group Families USA called the proposed change to the safety net health care program "a radical shift in CMS policy that violates federal law and is part of an ideological agenda that is hostile to government assistance with health coverage". That's because, absent the mandate, fewer low-income people will find out that they're eligible for Medicaid, especially in expansion states.
Verma, who served as a Medicaid consultant for IN and Kentucky before joining the Trump administration, has long advocated for work requirements.
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The Centers for Medicare and Medicaid Services argues that this draconian step will encourage more Medicaid beneficiaries to get a job and thus "promote better mental, physical and emotional health". The rules can't apply to people who are disabled. They will be exempt from the new requirements.
"A majority of adults covered by Medicaid who can work, do work - often two or three jobs in fields like the service industry that are less likely to offer insurance", Woodhouse said.
Asked whether that criticism extended to Cooper's proposal, a Price spokesman said simply that the congressman believes health care is a basic human right.
There were almost 2.9 million Pennsylvanians enrolled in Medicaid in November, with 144,971 of those in the Lehigh Valley.
"So I think you take those recommendations, embed it in, put it back on the Governor's desk and let him explain to taxpayers why people who are capable of working are not working", said Rep. Seth Grove, (R) - York County. Rep. Travis Cummings, R-Orange Park, introduced a bill that would have required all Medicaid beneficiaries who are part of the state's "managed medical assistance" program to adhere to the same work requirements that now apply to families who receive temporary cash assistance. The state's proposal would require Medicaid beneficiaries to work, job search, or care for someone with a disability for 20 hours per week. Likewise, he suggested, states should have similar rules for exemptions from work requirements in the various programs.
Most of the population that would qualify for Medicaid expansion already works, Venable said.
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The agency said it is encouraging states to consider a range of activities that could satisfy work and community engagement requirements.