"This new guidance paves the way for states to demonstrate how their ideas will improve the health of Medicaid beneficiaries, as well as potentially improve their economic well-being", CMS Deputy Administrator and Director for the Center for Medicaid and CHIP Services Brian Neale said. They also hearken back to the program's original intent, he added, "as temporary assistance to try to help people get back on their feet, not a permanent subsidy for someone's lifestyle, if they're capable of working". Most of those who don't work cite illness, disability or family obligations as the reason. Imposing a work requirement to be eligible for Medicaid not only fails to further the goal of providing health care, but also undermines the underlying objective.
Mary Beth Musucemi, associate director of the Kaiser Family Foundation's Program on Medicaid and the Uninsured, said the new approach "will penalize individuals by having them lose health coverage, rather than incentivize them, as a voluntary program with adequately funded supportive services necessary to overcome barriers would". But critics of the historic shift argue that the issue is far more complicated, and that if states do adopt the work requirements, millions of needy people's Medicaid coverage will be disrupted.
Edwards said he wants the work requirements to be "reasonable", with exceptions for people in school or training programs.
The federal guidelines say the administration would consider work requirements for "able-bodied, working-age" Medicaid recipients. "It is about taking away health insurance from low-income people". Under the Affordable Care Act, the program has expanded in more than 30 states to cover residents with somewhat higher incomes. Sharon Hewitt, a Slidell Republican, proposed the idea a year ago, but it went nowhere amid worries raised by the state health department and others about forcing people off Medicaid rolls.
Only 6% of Medicaid recipients not working surveyed said they were unemployed because they could not find a job, according to data from the Kaiser Family Foundation, a nonpartisan health policy think tank.
Walthall said she expects CMS to give IN full approval of its application, which would allow HIP to continue for another three years. The requests prompted CMS to issue today's guidance about how to obtain federal approval for waivers imposing work requirements on "able-bodied" adults.
For instance, the guidance notes that some Medicaid recipients may have trouble meeting these requirements because of poor health, substance abuse or high unemployment in their areas. States should ensure that career planning, job training, referral, and volunteering opportunities considered to meet the community engagement requirement, and job support services offered in connection with the requirement, take into account people's employability and potential contributions to the labor market.
The report also states that people with a full-time job are less likely to suffer from depression.More news: Tesco books steep rise in sales over Christmas
But it's not clear how many people would be affected by the new rules.
"Medicaid needs to be more flexible so that states can best address the needs of this population", Seema Verma, the head of CMS, said in a statement.
The work requirements will likely have an impact on a broad number of adults.
"I give CMS some credit for listening to 10 states", she said.
She is part of a team based at the U-M Institute for Healthcare Policy and Innovation that is evaluating Michigan's Medicaid expansion under contract with the state government.
A poll previous year from the nonpartisan Kaiser Family Foundation found that 70 percent of the public supported allowing states to require Medicaid recipients to work, even as most Americans opposed deep Medicaid cuts sought by congressional Republicans and the Trump administration. In the end, that state included in its Medicaid expansion only an encouragement of voluntary efforts by beneficiaries to train for work or find jobs.
IN is among 10 states with requests pending. In practical terms, they would represent new requirements for beneficiaries in those states.