Lawsuit Brewing As Kentucky Becomes First State To Get Approval To Impose Medicaid Work Requirements
In one of the biggest changes to the Medicaid program in its history, the Trump administration last week announced that it would allow states to seek new requirements from beneficiaries. Kentucky is now the first state to do so, but advocates are already threatening a lawsuit over the new guidelines. Media outlets offer closer looks at Kentucky's decision, the legal battle that will inevitably follow, who will be affected by the change, the political risk Republicans are taking, and more.
The New York Times:
To Get Medicaid In Kentucky, Many Will Have To Work. Advocates For The Poor Say They Will Sue.
Kentucky will be the first state to require many of its Medicaid recipients to work or face losing their benefits after the Trump administration approved its plan on Friday. Advocates for the poor threatened lawsuits, while Gov. Matt Bevin, a Republican, celebrated the approval as “the most transformational entitlement reform that has been seen in a quarter of a century.” (Goodnough, 1/12)
The Washington Post:
Kentucky Becomes The First State Allowed To Impose Medicaid Work Requirement
Becoming the first-in-the-nation state to move forward with the profound change to the safety-net health insurance program is a victory for Kentucky’s Republican governor, Matt Bevin, who during his 2015 campaign for office vowed to reverse the strong embrace of the Affordable Care Act by his Democratic predecessor. Bevin first pledged to undo the state’s expansion of Medicaid, which had helped to shrink the ranks of uninsured Kentuckians more than in almost any other state. He then pivoted to the idea of keeping the additional people in the program — with strings attached that the federal government had never permitted in Medicaid’s half-century history. (Goldstein, 1/12)
Politico:
Trump Administration OKs Medicaid Rollback In Kentucky
“Kentucky is leading the nation in this reform," Bevin said at a press conference Friday. “It will soon become the standard and the norm in the United States of America, and America will be better for it.” Conservatives see work requirements as a major victory, while progressive groups have vowed lawsuits to block them from taking effect. As Medicaid expanded to cover millions of low-income adults under Obamacare, Republicans have sought greater restrictions to curb swelling enrollment. That includes tying certain enrollees’ benefits to employment or other job-related activities, including job training or volunteer work. (Pradhan, 1/12)
NPR:
Kentucky Get Approved To Require Work From Medicaid Recipients
Nine other states — Arizona, Arkansas, Indiana, Kansas, Maine, New Hampshire, North Carolina, Utah and Wisconsin — have asked CMS to allow them to add "community engagement" requirements to their Medicaid programs. (Kodjak, 1/12)
Kaiser Health News:
Trump’s Work-For-Medicaid Rule Puts Work On States’ Shoulders
[S]tates considering whether to enact the controversial strategy face major hurdles. They will have to figure out how to define the work requirement and alternative options, such as going to school or volunteering in some organizations; how to enforce the new rules; how to pay for new administrative costs; and how to handle the millions of enrollees likely to seek exemptions. Take Arizona, one of the 10 states that have applied for federal approval for a work requirement. The state must settle basic questions, including whether people would have to meet the new conditions at the time of enrollment, at the annual renewal of their Medicaid coverage or at another time. (Galewitz and Bartolone, 1/12)
The Wall Street Journal:
Trump Administration Approves Kentucky Plan Requiring Medicaid Recipients To Work
The approval from the Centers for Medicare and Medicaid Services is expected to face swift legal opposition from consumer groups, who say work requirements violate the guarantee that people who meet certain income criteria will get health coverage. Republicans portray this first-ever work mandate as a way to reduce what they say is a mushrooming dependence on the federal-state program by leading to jobs and self-sufficiency. (Armour, 1/12)
The Hill:
Court Battle Brewing Over Work Rules For Medicaid
A battle is brewing in the courts over the Trump administration's move to let states impose work requirements for recipients of Medicaid, the health insurance program for the poor. Advocacy groups are gearing up to sue the administration, arguing that it doesn’t have the power to allow work requirements and other rules for Medicaid without action from Congress. (Roubein and Sullivan, 1/15)
The Associated Press:
Medicaid Work Mandate Will Create Uncertainty In Some States
Republicans this past week began to realize their long-held goal of requiring certain adults to work, get job training or perform community service in exchange for getting health coverage through Medicaid. Whether that's a commonsense approach or an added burden that will end up costing many Americans their health insurance will now be debated in states across the country considering the landmark change to the nation's largest health insurance program. (1/14)
NPR:
Medicaid Restrictions That Require Recipients To Work Miss The Point, Critics Say
Medicaid's chief federal officer is Seema Verma; her home state of Indiana submitted plans for a work requirement last year, and the approval letter could come any day now. Under the proposal, people would have to average 20 hours a week of work or another qualifying activity — such as volunteering or getting an education — to get Medicaid. The goal is to increase employment among Medicaid recipients. But Sara Rosenbaum, a professor of health law and policy at George Washington University, says there's a problem with that — most people on Medicaid are already working, or looking for work. Or they're caring for a child or family member, or they're sick or disabled. (Harper, 1/12)
Kaiser Health News:
Kentucky Is First State Granted Approval For Medicaid Work Requirements
Surveys show that many Medicaid enrollees who don’t work are in job training, go to school or are taking care of a child or an elderly relative, conditions that would make them exempt from the new mandate, according to the CMS guidelines. (Galewitz, 1/12)
The Hill:
Five Things To Know About Medicaid Work Requirements
The Trump administration released landmark guidance this week aimed at allowing states to impose work requirements for Medicaid beneficiaries, a major shift in the design of the health insurance program for the poor and disabled. Here are five things to know about work requirements. (Weixel, 1/15)
Marketplace:
Work Requirements For Medicaid Raise Questions For Insurers
States are crafting new Medicaid policies, now that the feds have said they can require people to work in order to qualify for coverage. That will likely mean more customer churn, people moving in and out of Medicaid programs as their employment status changes, or they learn to comply with new mandatory premiums. (Gorenstein, 1/15)
Reuters:
Political Risk Looms Over Republicans' Welfare Tinkering
Political danger signs are flashing, but conservatives in Washington are pushing forward with proposals to change America's social safety net, an agenda even fellow Republican President Donald Trump recently shied away from. Fresh from a tax overhaul victory and keen to act while they retain control of Congress, Republicans are seeking tougher work and job training requirements for those helped by assistance programs such as Medicaid and food stamps. (Cornwell and Abutaleb, 1/12)
Kaiser Health News:
Podcast: ‘What The Health?’ Should You Work For Your Medicaid Coverage?
The Trump administration this week told states they will be allowed to require some beneficiaries of the Medicaid program to work or perform community service in order to keep their health insurance — a break with long-standing policies of both Democratic and Republican administrations. (1/12)
CQ:
Need A Doctor? Get A Job!
A group of mostly Republican-led states stand poised under the Trump administration to make a first-of-its-kind change to Medicaid since the government health program for the poor was created more than half a century ago. Arkansas, Kentucky, Indiana and at least seven other states want to require tens of thousands of so-called “able-bodied” adults to join a jobs program or risk losing the health care services they need. The aim: promote self–reliance and rein in costs by moving people off the Medicaid rolls. (Williams, 1/16)
And in the states —
Raleigh News & Observer:
NC Wants To Require Medicaid Recipients To Work. Here’s What Would Have To Happen Next.
North Carolina could be among the first states in the country to require Medicaid beneficiaries to hold down a job as a condition of receiving free health insurance from the government. ... The N.C. Department of Health and Human Services made its request in November as part of a broader request to change the way Medicaid is administered. If approved, the work requirement would not automatically go into effect; it is contingent on the N.C. General Assembly passing House Bill 662, known as Carolina Cares. The bill would expand Medicaid to several hundred thousand residents – but with conditions, including that they pay monthly premiums for their government health insurance, and that they work. (Murawski, 1/15)
Concord Monitor:
As N.H. Nears A Medicaid Work Requirement, Dems Remain Skeptical
It took two years and a change in presidential administrations, but a long-sought federal waiver to add a work requirement to New Hampshire’s Medicaid expansion appears within reach. On Thursday, the federal Centers for Medicare and Medicaid Services, known as CMS, issued a letter to state governors allowing states to apply for work requirement waivers to the Medicaid expansion program. (DeWitt, 1/16)
News Service of Florida:
Florida Unlikely To Mandate Work For Medicaid, Officials Say
While the Trump administration signaled willingness to allow work requirements for Medicaid beneficiaries, the Florida Legislature is unlikely to move ahead with such a mandate this year. House Speaker Richard Corcoran, R-Land O'Lakes, said Wednesday the state's $26 billion Medicaid program is comprised mostly of children and seniors and that work requirements are more geared toward able-bodied adults who qualify for Medicaid under the Affordable Care Act, commonly called Obamacare. (1/14)