The state's Medicaid department is already in the process of applying for a waiver to add work requirements, which was part of the budget passed previous year. Some states received federal waivers to test new ideas on how to administer the program.
In its guidance issued Thursday, CMS said it would support state requests to require adult Medicaid beneficiaries to work or engage in skills training, education, job search, caregiving or volunteer service. This would exclude individuals eligible for Medicaid due to a disability, elderly beneficiaries, children, and pregnant women.
In those states that receive a waiver for the work requirements, those now working will be required to provide documentation that they are working, and those who are not will be required to prove that they should be exempted.
Homeless people, former foster children and American Indians are among individuals who would be exempt from Arizona's proposed Medicaid work requirements, the state's application says.
Kentucky is expected to be the first state to get permission, but IN also expects its waiver request to be approved IN the coming days. Demonstrations, which give states additional flexibility to design and improve their programs, are also created to evaluate state-specific policy approaches and better serve Medicaid populations.
"Eligible people could end up losing coverage because the right documentation does not get sent to the right place", said MaryBeth Musumeci, associate director of Kaiser's Program on Medicaid and the Uninsured.
"Medicaid was designed as a health care program, to provide vulnerable members of our society with access to care they badly need", Ende wrote.
The guidance represents a fundamental and much-disputed recalibration of the compact between the government and poor Americans for whom Medicaid coverage provides a crucial pathway to health care.
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"Most people on Medicaid are working and there's no evidence that penalizing the small number on Medicaid that can't work, taking away their healthcare, somehow improves economic activity or does anything except making things worse by taking away healthcare", she told NM Political Report.
Verma, who served as a Medicaid consultant for IN and Kentucky before joining the Trump administration, has long advocated for work requirements.
The Centers for Medicare and Medicaid (CMS) administrator, Seema Verma, said on Twitter the new effort will "improve Medicaid enrollees health outcomes by incentivizing community engagement".
"There's absolutely nothing that requires the exemption of people with addiction", Rosenbaum said.
Those who don't comply would be suspended from receiving health care benefits until they meet their required hours for a month.
"My only hope is that the chaos caused by this policy and the desperation of the Kentucky families who will soon lose their only access to health coverage will force Gov. Bevin to demonstrate some level of compassion and reverse this disgraceful policy", Yarmuth said. The state has one of the highest rates of overdose deaths in the country, and its Medicaid spending on prescriptions for opioid use disorders jumped 326 percent from 2011 to 2016, to $64 million. "It will actually help this population reap the rewards of a good job, and one day receive health care coverage from their employer, not the state or federal government". Patty Murray, D-Washington, the ranking Democrat on the Senate health committee, said it "speaks volumes" about President Trump's priorities that CMS would pursue a policy she said would "pull the rug out from people who simply want affordable health care they can rely on". But states will be given a loose rein on what satisfies the work requirement. "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". That represents about 15 million people.
Ten states, all of which have Republican governors, recently applied for waivers to impose work requirements. Additionally, the guidance details that states can not accrue savings from loss in enrollment due to work requirements, which means that states will need to pay for any work requirement administrative burden, such as determining if an individual is working, developing an enrollee reporting system and employment supportive services, etc.