Louisiana governor considering work requirements in Medicaid

Seema Verma

Louisiana is developing a proposal to impose work requirements on certain adult Medicaid recipients, as the Trump administration announced Thursday it will allow states to enact such provisions.

"We look forward to working with states interested in testing innovative approaches to promote work and other community engagement, including approaches that make participation a condition of eligibility or coverage, among working-age, non-pregnant adult Medicaid beneficiaries who qualify for Medicaid on a basis other than a disability", the CMS letter said.

Verma said the agency wants to give states as much latitude as possible to try out their own ideas.

The Centers for Medicare and Medicaid Services issued guidance making it easier for states to design and propose test programs that implement such requirements, according to a Reuters report. In states that decide to impose the new requirement, it is widely expected to shrink Medicaid rolls.

But it's not clear how many people would be affected by the new rules.

"It is stupid because it will actually prevent people from working - with health needs unattended, many low-income people will be unable to seek work", Robert Weissman, president of liberal advocacy group Public Citizen, said in a statement.

"States have the opportunity to help individuals improve and enhance the skills that employers truly value", Verma said.

The states are: Arizona, Arkansas, Indiana, Kansas, Kentucky, Maine, New Hampshire, North Carolina, Utah and Wisconsin.

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The administration said states imposing work rules must have plans to help people meet those requirements and must connect them with job training, but could not use federal Medicaid funds to pay for such "supportive services".

FILE PHOTO: Administrator of the Centers for Medicare and Medicaid Services Seema Verma speaks after being sworn in by U.S. Vice President Mike Pence in Washington, U.S., March 14, 2017.

Republicans lawmakers have repeatedly failed to repeal and replace Obamacare, a top Trump campaign promise. State Sen. Sharon Hewitt, a Slidell Republican, proposed the idea previous year, but it went nowhere amid worries raised by the state health department and others about forcing people off Medicaid rolls. "Healthcare is a right that shouldn't be contingent on the ideological agendas of politicians". A study in December in JAMA Internal Medicine found that about half of the Medicaid recipients in MI were already working. The Obama administration rejected prior waiver requests from states to add work requirements.

The administration is nonetheless expected to quickly approve requests from as many as 10 states, all but one of which has a Republican governor.

For instance, Kentucky past year proposed work requirements for able-bodied adults to get insurance and establishing new fees for all members based on income.

Democrats and health care advocacy groups have long opposed work requirements on policy grounds as well, however, warning they would stigmatize Medicaid recipients and leave too many poor Americans uncovered and vulnerable to catastrophic medical costs or untreated health problems. A study found the proposal would reduce the number of residents on Medicaid by almost 86,000 within five years, saving more than $330 million.

But Trump administration officials said Thursday that work requirements were consistent with the goals of Medicaid, because work and other community engagement activities could improve the health of Medicaid beneficiaries.

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