The Trump administration has announced plans to help states implement work requirements for Medicaid.
The guidance says states should promote programs that will better Medicaid beneficiaries' physical, mental, and emotional health while helping them and their families rise out of poverty and gain independence.
"CMS will support state efforts to test incentives that make participation in work or other community engagement a requirement for continued Medicaid eligibility or coverage for certain adult Medicaid beneficiaries in demonstration projects authorized under section 1115 of the Social Security Act," the agency states.
The agency suggests that community engagement and feeling productive at work can promote wellness, and having a higher income is positively associated with a longer lifespan. Other studies find that unemployment is related to poorer health, higher mortality, poorer mental health, and higher hospital admission rates.
"CMS supports state efforts to enable eligible individuals to gain and maintain employment," the agency explains. "Optional Medicaid programs such as the Medicaid Buy-In, for example, allow workers with disabilities to have higher earnings and maintain their Medicaid coverage."
"For beneficiaries who are able to work but have been unable to find employment, some states encourage employment through concurrent enrollment in state-sponsored job training and work referral, either automatically or at the option of the Medicaid beneficiary," the agency says. "A number of states have also initiated programs to connect nondisabled Medicaid beneficiaries to existing state workforce programs."
Kentucky has just received approval from the Trump administration to implement their work requirements, which mirror their requirements for food stamps. There are 650,000 Medicaid beneficiaries in Kentucky. Many of these individuals do not have any earned income and do not work at all. Under the new requirements, these beneficiaries will have to either work, train, or volunteer for 20 hours a week in order to receive benefits.
According to research from the Foundation for Government Accountability, the number of Medicaid beneficiaries has more than doubled since 2000. Now 75 million are enrolled in the program, which includes 28 million able-bodied adults. In addition, 52 percent of Medicaid beneficiaries that are able-bodied do not work.
"Today's guidance is a critical step for the Medicaid program and millions of able-bodied adults trapped in dependency," says Tarren Bragdon, CEO of the foundation. "Work is the key to their futures. With today's guidance, states have a clear roadmap to move millions of able-bodied adults from welfare to work and preserve resources for the truly needy."
"We expect rapid adoption of this new option in the states," he said. "We applaud the Trump administration's active commitment to reducing dependency and moving Americans from welfare to work."
Douglas Holtz-Eakin, president of the American Action Forum, says many states have expanded Medicaid through the Affordable Care Act, which brought able-bodied individuals with no children who are above the poverty line into the program. He also argues that the work requirement is not really a work requirement.
"It is a ‘community engagement' requirement that may be satisfied by work, volunteer work, education, career planning, job training, and other activities," he said. "The work requirements will be subject to an evaluation to determine their effectiveness."