President Donald Trump allows U.S. states work rules for Medicaid enrollees

Centers for Medicare and Medicaid Services administrator during her Senate Finance Committee confirmation hearing in Washington on Feb. 16 2017. MUST CREDIT Bloomberg

Centers for Medicare and Medicaid Services administrator during her Senate Finance Committee confirmation hearing in Washington on Feb. 16 2017. MUST CREDIT Bloomberg

The guidance also includes caregiving as one of the activities. "Our fundamental goal is to make a positive and lasting difference in the health and wellness of our beneficiaries, and today's announcement is a step in that direction", said CMS Administrator Seema Verma. "Conservatives who favor work requirements see Medicaid coverage as another form of government welfare benefit, like cash assistance, requiring reciprocal obligations from beneficiaries, and a disincentive to work".

Critics of the Trump administration's change fear many will be unable to meet the mandate and be left uninsured, especially those battling mental illness and opioid addiction. These are individuals who are physically capable of being actively engaged in their communities, whether it be through working, volunteering, going to school or obtaining job training. No state or federal administrator can add another requirement that is not in federal law. In 1985, Medicaid spending consumed less than 10 percent of state budgets and totaled just over $33 billion. Its sweeping 2006 law - signed by then-Governor Mitt Romney, a Republican - created near-universal coverage for the state's residents.

"Justifying work requirement that will cut people off #Medicaid by citing #Medicaid initiatives that provide support to people with disabilities so they can work is perverse". However, they will not be allowed to use federal Medicaid funding to finance these services.

Republicans have long wanted to add work requirements for Medicaid recipients - which covers almost 75 million low-income children, adults and elderly and disabled Americans.

"The state has little evidence for why the current Gateway to Work program would fare better if mandatory", wrote Jon Laramore, executive director of Indiana Legal Services. And CMS head Seema Verma has always been a proponent of such measures.

Medicaid covers about half of the babies born in this country, she said.

The Trump administration made a major health care policy shift by saying that states could impose work requirements for people on Medicaid. They want to develop programs that will help them break the chains of poverty and live up to their fullest potential. "The cost of implementing work verification, education verification is actually, end costing more than you save by implementing it".

On Thursday, the Trump administration announced new policy guidance allowing states to require people on Medicaid work or volunteer to maintain eligibility. Two-thirds of Medicaid recipients in MI who are "out of work" say they have a chronic illness. People who are elderly or disabled, and pregnant women and children, would be excluded. CMS also said it will help states align Medicaid work and community engagement requirements with SNAP or TANF requirements. "Those days are over". Republicans tout them as a way to push non-disabled, unemployed Medicaid recipients to reenter the workforce. Only about 1 in 10, per Kaiser's numbers, didn't work and didn't qualify for one of these exemptions.

CMS Administrator Seema Verma, MPH, had previously signaled the change was coming in a November 2017 speech to the National Association of Medicaid Directors on expanding what changes states can make through Section 1115 waivers. Those who are deemed "medically frail" or have an acute condition that prevents them from working are also exempt.

Advocacy groups said most Medicaid recipients already have jobs, and those who do not may have difficulty accessing transportation to get to and from work or need to care for family members. Medicaid is pretty different from even other government health care programs; its beneficiaries are the poorest people in America, kids, and people with disabilities-a coalition of Americans who often have the most hard health care needs in the country compared with the employer-sponsored private health market.

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