Thursday, 18 January, 2018

Nation Medicaid work requirements approved for Kentucky

Kentucky Gov. Matt Bevin left and President Trump during a prison reform roundtable on Thursday Kentucky Gov. Matt Bevin left and President Trump during a prison reform roundtable on Thursday
Lillian Steele | 14 January, 2018, 00:31

Matt Bevin said at a press conference announcing the waiver approval that he expects his state to "become the model of the nation".

But Bevin said Friday the community engagement feature will allow Kentuckians on Medicaid "the respect and dignity to do something for themselves".

"Our focus in Washington's Medicaid program is promoting the health and well-being of our state residents and communities, and the majority of Apple Health clients do work", said HCA Director Sue Birch in a statement.

But Senate Health and Human Services Appropriations Chairwoman Anitere Flores, R-Miami, said the Senate has not discussed requiring those now enrolled in the program to work.

While Bevin said that Kentucky's new program, called HEALTH (Helping to Engage and Achieve Long Term Health) would improve Kentuckians' health outcomes, critics, including U.S. Rep. John Yarmuth, D-Ky., said it would kick tens of thousands of people off health insurance.

"Kentucky HEALTH is specifically tailored with the unique needs of Kentuckians in mind".

The Trump administration gave Kentucky permission Friday to impose work requirements on its Medicaid recipients, making the state the first in the nation to implement the administration's new policy of allowing states to make Medicaid coverage contingent on work.

Kentucky says able-bodied adults need to prove they've done at least 80 hours of work a month to get their benefits.

Under the now-approved program Kentucky submitted past year, adults 19 to 64 will have to perform 80 hours a month of "community engagement", which could include paid work or activities like school, job training and volunteering.

Under the rules, states can require Medicaid beneficiaries to work, volunteer or participate in job training.

However some IL patient advocates said they hope the state doesn't submit a proposal to make having a job a condition of Medicaid eligibility, citing fears it would leave people without health insurance. "Cutting off peoples' ability to get to a doctor when they need to only makes it harder for them to keep working, or find meaningful employment".

And, of course, people who can't meet a work requirement will not cease seeking medical care; they will get it as they used to before Medicaid, by showing up at emergency rooms, where they must be treated, often at higher expense than would have been the case if they had insurance. "Keeping up with the reporting requirements alone will be enough of a burden on people who have two or three part-time jobs that they'll either lose coverage at some point or may decide it's not worth enrolling to begin with". They wouldn't regain it until they've paid all of their missed premiums.

New Hampshire is one of 33 states that opted to expand eligibility for Medicaid to embrace a larger portion of the population through the Affordable Care Act (Obamacare).

The state also eliminates its non-emergency transportation benefit for some adults in the program. Kentucky HEALTH introduces innovative delivery system reforms for the treatment of substance abuse, and a first-ever community engagement initiative for Kentucky HEALTH members created to improve their health and strengthen Kentucky's workforce. Pregnant women and children will be exempt from that cost sharing. What risks and challenges do you see with implementing these work requirements as this opioid crisis continues?

Medicaid now covers one in five Americans - about 73.5 million Americans. Almost 60 percent work either full time or part time, mainly for employers that don't offer health insurance.

Seema Verma, the administrator of CMS, has lauded the new guidance as a step forward for Medicaid and public health.

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