Trump Launches 'Truly Savage' Attack on Medicaid By Pushing Work Requirements

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The Centers for Medicare and Medicaid Services on Thursday confirmed it will accept state Medicaid waivers that include work requirements as a condition for eligibility.

The ruling affects nine other states, eight of which - like North Carolina -are led by Republican-controlled legislatures.

A University of MI team recently published data in JAMA Internal Medicine from detailed survey of more than 4,000 MI residents enrolled in the state's expanded Medicaid program.

Seema Verma, head of the Centers for Medicare and Medicaid Services, said requiring work or community involvement can make a positive difference in people's lives and in their health.

Verma said the agency wants to give states as much latitude as possible to try out their own ideas.

But most health policy experts, including a few noted conservatives, have regarded the government insurance enabling millions of people to afford medical care as a right that should not hinge on individuals' compliance with other rules. "Some state House Republicans support increased access to Medicaid with a work requirement, and although the Governor has serious concerns about that, he's pleased that there is some movement on this".

While more than 74 million people are enrolled in Medicaid, only a small fraction would be affected by the work requirement.

Families USA said the decision represents "a radical shift in CMS policy that violates federal law and is part of an ideological agenda that is hostile to government assistance with health coverage".

States wouldn't be able to request work requirements for disabled people and children under the new guidance; however, a number of nonpartisan health care think tanks point out that many Americans who rely on Medicaid can not work because they are the primary care providers for much sicker family members or live with other socioeconomic realities that make finding work more hard.

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Verma, who served as a Medicaid consultant for IN and Kentucky before joining the Trump administration, has long advocated for work requirements.

States will be required to describe strategies to assist recipients in meeting the requirements and to link them to job training and support resources, including child care and transportation.

Verma also said that any drop in Medicaid rolls as a result of work requirements would stem from people no longer needing it.

Administrator Verma cited the Administration's firm commitment to combat our nation's opioid crisis and the letter outlines that CMS will require states to make reasonable modifications for individuals with opioid addiction and other substance use disorders.

A study by the nonpartisan Kaiser Family Foundation found that nearly 60% of working-age Medicaid recipients are already employed full time or part time. 30% said they were watching over a relative, while 15 percent said they would school.

Such regulations are already in place for most recipients of Supplemental Nutrition Assistance Program, commonly known as food stamps.

For close to a year, the administration has signaled an interest in helping states that want to institute work requirements. "The analysis noted that, 'More than one-third of those not working reported that illness or disability was the primary reason for not working. almost nine in ten (88%) non-SSI Medicaid adults who report not working due to illness or disability has a functional limitation, and more than two-thirds (67%) have two or more chronic conditions such as arthritis or asthma'". The remaining 27 percent were not working, but two-thirds of them had a chronic mental or physical health condition, and one quarter of them said this condition interfered with their ability to function on a daily basis.

CMS said the requirements "should take into consideration areas of high unemployment or care giving for young children or elderly family members".

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