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Kentucky to add Medicaid work requirement

Kentucky to add Medicaid work requirement

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.

Rewriting the rules on health care for the poor, the Trump administration said Thursday it will allow states to require "able-bodied" Medicaid recipients to work, a hotly debated first in the program's half-century history.

Kentucky, for example, will require able-bodied adults to complete 80 hours a month of community engagement to qualify for coverage.

Ten states have already sought federal permission to impose Medicaid work requirements through that allow them more flexibility to create policies designed to promote financial responsibility among enrollees.

Red states are most interested.

A work requirement makes plain that the welfare state is a helping hand for people in need, even long-term, but that it should never become a way out of a regular adult life for those who can and should support themselves but prefer not to.

Here are five things to know about work requirements.

Medicaid now covers a broad cross-section of people, from many newborns to elderly nursing home residents, and increasingly working adults.

Gov. Matt Bevin has announced that the federal Centers for Medicare and Medicaid Services (CMS) has approved the Commonwealth's Section 1115 Medicaid waiver known as Kentucky HEALTH. Verma said they wouldn't be affected by the new policy.

"Kentucky can not afford the cost of the Medicaid expansion program without this demonstration waiver", the state's waiver application said. In addition, Kentucky HEALTH will ensure availability of Medicaid resources to our most vulnerable citizens by saving an initial estimated $2 billion dollars (federal and state) over the waiver demonstration period, allowing these funds to be focused on those most in need and other critical areas.

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Yet with health care, as with food, the state often has a duty to provide it to those who, despite their best efforts, would be incapable of providing it for themselves.

Leonardo Cuello, director of health policy at the National Health Law Program, added the new policy was "legally suspect" because HHS allegedly skirts the established notice and public comment periods under which major policy changes are typically introduced.

Thursday's administration guidance to states spells out safeguards that states should consider in seeking work requirements.

But blue states likely have no interest in forcing Medicaid recipients to work for their benefits.

Prodding people to engage them in work-related activities is fine, said Gail Wilensky, a senior fellow at Project HOPE who ran the Medicaid program from 1990 to 1992 under President George H.W. Bush.

"You might find yourself swapping a tightly managed narrow-network Medicaid program for a fragmented, expensive emergency room care", said Wilensky, a conservative Republican.

Yet his story also helps make the case for those who favor some type of commitment from working-age adults who benefit from Medicaid, the state-federal health care program for poor and lower-income Americans. Twenty-eight percent reported care-taking obligations, while 18 percent couldn't work because they were in school. Each vote to expand Medicaid in recent years in the Granite State has had a sunset date; the current expiration date is at the end of 2018. If they can show a correlation between work and improved health outcomes, they could have a strong argument.

The big issues: Will they figure out ways to get the needed money or do people on Medicaid face big cuts?

Verma said that the administration of President Trump, a Republican, will approve the work requirements that had been denied under President Obama, according to a report from Kaiser Health News.

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