Trump Administration Announces State Work Requirements for Medicaid

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The Trump administration has announced its decision to allow states to impose work requirements on residents receiving Medicaid. Over 70 million Americans are currently enrolled in Medicaid, which provides health insurance for low-income individuals who are otherwise unable to receive benefits. Federal officials say work requirements will improve the overall health of beneficiaries, leading to lowered costs for taxpayers. Opponents of the decision, however, say it may have a devastating impact on an already vulnerable section of society.

Administrator of the Centers for Medicare and Medicaid Services Seema Verma stated that the announcement was in response to several states’ requests to begin testing projects regarding work requirements. Arizona, New Hampshire, Kansas, Arkansas, Indiana, Utah, Kentucky, Maine, North Carolina and Wisconsin submitted proposals asking to run demonstrations evaluating the use of job training, education, volunteer opportunities and other activities as requirements for Medicaid beneficiaries.

Along with the Trump administration’s announcement, the Centers for Medicare and Medicaid Services released a guidance that outlines states’ roles in implementing the change. The guidance gives states some flexibility in determining what types of activities should be counted toward work requirements and grants exemptions for certain groups, such as pregnant women. Since many individuals receiving Medicaid struggle with poor health, the guidance recommends that states allow for modifications. However, it does not specify what these modifications would be, an issue that critics of the change say leaves too much up to chance.

The Kaiser Family Foundation notes that many Medicaid beneficiaries with chronic mental and physical health problems rely on Medicaid because they don’t meet the criteria for federal programs. These individuals still struggle to work because of their health issues, but many will not be allowed an exemption under the new Medicaid requirements. Kaiser’s analysis of recipients shows that 60 percent of non-disabled individuals who receive benefits have a job, with 80 percent of recipients living in a family unit with at least one person in the work force.

While Verma and the Trump administration claim the change will allow states to support their residents in improving their overall health, citing the longer lifespan of working individuals as an example, state Medicaid agencies will not receive any federal funds to assist in the creation of work support programs. As the Kaiser Family Foundation notes, very few state agencies currently have the capacity to develop and provide work support programs on their own.