It has improved low-income people's financial health, helped states fight the opioid epidemic, and improved access to care. "The most vulnerable people are the ones who need Medicaid coverage the most, and they will lose it", Pavetti said.
A large majority of Medicaid recipients - nearly two-thirds - are children, elderly or disabled.
According to federal officials, states would have the support of the administration if they wanted to make Medicaid recipients find work or engage in other "community engagement activities".
But others, like Frank Pallone Jr. of New Jersey, the senior Democrat on the House Energy and Commerce Committee, said that the move was nothing but "cruel".
An advocacy group in ME vowed to fight the waiver, arguing that it's illegal and that the current Medicaid program supports work by giving people access to health care, making them more likely to stay well enough to be employed. For example, they said, states could reduce the number of hours of work required of people with certain kinds of disabilities.
The states that will end up implementing these work requirements are also the states that tend to be the poorest to begin with, such as Kentucky (the fourth poorest in the country) and Arkansas (the sixth-poorest), furthering the unconscionable poverty and negative health outcomes associated with it.
Opponents said the administration had it backwards, saying healthier people are able to work, not that working people are healthier.
"The guidance was just released and we will assess accordingly as we do with any guidance, however the administration does not support applying work requirements to the MassHealth program", Baker spokesman Brendan Moss said in a statement to the News Service. Under the Affordable Care Act, states were permitted to expand their Medicaid programs for low-income individuals at or near the poverty line, providing health insurance to those who would struggle to afford coverage even with tax subsidies provided under the law. About 72 million people, more than one-fifth of the American population, had Medicaid coverage in 2017, according to CMS.
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Republicans said Mr. Trump's stance is a much-needed reversal that will return the program's focus to the truly needy, while steadying federal and state budgets. For instance, most Medicaid enrollees who can work, do.
Thursday's announcement wasn't a huge surprise.
CMS said in the letter the new guidance allows states to experiment with the idea of work requirements (or related activities such as skills training, education, job search, caregiving, volunteer service) "in order to determine whether those requirements assist beneficiaries in obtaining sustainable employment".
In addition, federal officials said, providing care for young children or elderly family members can sometimes qualify as work. People receiving TANF cash assistance or SNAP food benefits who meet those programs' work requirements will be considered in compliance with Medicaid's rules. "And so the net effect of this policy isn't going to be to get more people to get jobs, it is for more people not to have health care, they are going to get sicker and have less ability to get jobs". For instance, time spent in medical treatment may count toward community engagement time, while those in intensive treatment may be exempt.
According to a recent analysis by the nonprofit Kaiser Family Foundation, 6 in 10 of the almost 25 million working-age, nondisabled adults on Medicaid already work full time or part time. "It is telling that both the Trump administration and the states proposing work requirements also have proposed major cuts to Medicaid that would take away coverage from millions of people".
To be approved for a waiver, states have to show that their plan is revenue neutral.
"I think it's a whole host of reasons why they might not 'comply'".
While more than 74 million people are enrolled in Medicaid, only a small fraction would be affected by the work requirement. Those deemed "medically frail" and pregnant women will be exempted, and states must prove they are not inappropriately denying coverage to those with disabilities. The liberal Families USA said Thursday it's working with the National Health Law Program and other groups on a challenge.