The Trump administration has made major headway toward allowing states to impose work requirements for Medicaid recipients, tying the two together for the first time in the program’s 52-year history.
A new policy guidance from the Centers for Medicare and Medicaid Services says that states will be free to create programs that require Medicaid recipients to prove that they’re working, training for a job or volunteering—proof similar to what’s asked of Supplemental Nutrition Assistance Program (SNAP) and Temporary Assistance for Needy Families (TANF) recipients.
CMS administrator Seema Verma painted the guidance as a helpful step to promote employment among able-bodied Americans, despite the fact that 60 percent of Medicaid’s non-elderly recipients already have jobs, according to a study by the Kaiser Family Foundation. Of those who do not work, more than a third are ill or disabled, 30 percent are caring for young children and 15 percent are in school.
Asked about those whose coverage will likely be canceled as a result of the policy, Verma insisted that decreased enrollment would mean only that more people are finding coverage through their employers.
“People moving off of Medicaid is a good outcome because we hope that that means they don’t need the program anymore,” she said during a press call.
Brian Neale, director of the federal Medicaid office, added to the program’s insane pile of justifications by suggesting that Medicaid recipients are actually harming themselves by staying voluntarily locked away in their homes all day.
“Productive work and community engagement may improve health outcomes,” he said. “For example, higher earnings are positively correlated with longer lifespan.”
Advocates have pointed out the obvious idiocy of that logic. Brad Woodhouse, campaign director of Protect Our Care, called the new policy “the latest salvo of the Trump administration’s war on health care.”
“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,” he said.
Ten states so far have expressed interest in testing the work-for-Medicaid model, with proposals coming from Arizona, Arkansas, Indiana, Kansas, Kentucky, Maine, New Hampshire, North Carolina, Utah and Wisconsin. Of those, Kentucky will likely be the first to implement the new requirements.