Kentucky Gets OK To Require Work From Medicaid Recipients

Maricruz Casares
Enero 13, 2018

Bevin is calling the waiver "Kentucky HEALTH".

The LePage administration is also proposing to charge a group of people earning poverty-level incomes monthly premiums, and to charge them when they use the emergency room for what DHHS determines to be non-emergencies.

Before Verma joined CMS she was a private consultant and an architect of the Kentucky plan that was approved Friday.

The announcement came in a 10-page memo with detailed directions about how states can reshape the federal-state health program for low-income people.

The Trump administration announced Thursday it will allow states to require some Medicaid recipients to work. And when someone gets sick, the last thing she needs to worry about is whether she'll also lose her health coverage for not working.

"It's conceivable", he said.

Bevin sidestepped questions about possible savings from the plan, although he had projected it could save Kentucky more than $300 million in Medicaid costs over the five-year life of the proposal when he announced it in 2016.

The Bevin administration says it will reach out to enrollees starting Friday, and the program will kick off in July.

Still, critics fear a work requirement could have a chilling effect on people signing up for Medicaid or make it harder for people to get coverage. "While we are still reviewing the details of this approval, we have yet to identify such an experiment, and the action appears created to achieve significant cuts in Medicaid enrollment rather than Medicaid's stated objective of furnishing medical assistance to low-income people", Perkins said. It is the nation's largest health insurance program. "It's not about employment encouragement".

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.

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Meanwhile, many of those who don't work are going to school or caring for children or other family members, and many others are ill or disabled but haven't been able to officially qualify for federal disability insurance. Whether called "work requirements" or "community engagement", these bureaucratic provisions will be costly and time-consuming. (Those figures also include some disabled enrollees).

While more than 74 million people are enrolled in Medicaid, only a small fraction would be affected by the work requirement. That's if they receive notification or understand new rules of the program, he said.

Health groups and advocates for the poor - including the National Center for Law and Economic Justice and the American Lung Association - dispute Verma's contention that the Centers Medicare and Medicaid Service has the authority to grant such requests.

"There is a real risk of eligible people losing coverage due to their inability to navigate this process or miscommunication or other breakdown in the administrative process", she said in an email to HuffPost.

Finally, the work requirements will be subject to an evaluation to determine their effectiveness.

The federal government has wide latitude to grant states such waivers.

Cuello said CMS has it backward, arguing people need to be healthy in order to work. It says states must "take certain steps" to provide coverage for people in need of substance abuse treatment, potentially by counting time a person spends in treatment toward work requirements or by exempting those participating in "intensive medical treatment".

Kentuckians on Medicaid won't see any immediate changes. Officials in several other states have said they are interested in the idea.

Verma said that the administration of President Trump, a Republican, will approve the work requirements that had been denied under President Obama, according to a report from Kaiser Health News.

Update: This story was updated on January 12 to add information from the governor and more details on the Kentucky waiver once they were released.

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