Thursday, 18 January, 2018

President Donald Trump backs Medicaid work requirements Video

The Trump administration has announced it is offering a path for states that want to seek work requirements on Medicaid recipients Health Highlights: Jan. 11, 2018
Lillian Steele | 12 January, 2018, 03:24

The Trump administration early Thursday initiated a pivotal change in the Medicaid program, announcing that for the first time the federal government will allow states to test work requirements as a condition for coverage.

North Carolina is one of 10 states that wants to add work requirements to its Medicaid program.

"Medicaid needs to be more flexible so that states can best address the needs of this population", Seema Verma, the head of CMS, said in a statement.

"It is a very major change in Medicaid that for the first time would allow people to be cut off for not meeting a work requirement, regardless of the hardship they may suffer", said Judy Solomon of the Center on Budget and Policy Priorities, which advocates for poor families.

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

The conditions would exclude individuals eligible for Medicaid due to disability, elderly beneficiaries, children and pregnant women.

Several states had previously addressed the notion of cutting off Medicaid benefits to people who can work, but don't, but the idea was repeatedly refused by former President Barack Obama's government, CNN reported Thursday. "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". Many of them have jobs that don't provide health insurance.

In order to implement any new policy based on the guidance, states would have to propose the changes through waivers and wait until they are granted federal approval.

Asked whether that criticism extended to Cooper's proposal, a Price spokesman said simply that the congressman believes health care is a basic human right.

"This action by the Trump administration goes after people who are just trying to get by", Democratic U.S. Senator Ron Wyden of OR said.

Seema Verma, head of the CMMS said work and community involvement can make a positive difference in people's lives and in their health
Seema Verma, head of the CMMS said work and community involvement can make a positive difference in people's lives and in their health

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. Many Republican-governed states declined to take part in the expansion. 36% said they were ill or disabled, 9% said they were retired, and 30% said they were taking care of family or their home.

In a statement released this afternoon, Baker's office said it "does not support applying work requirements to the MassHealth program". "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 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.

The Obama administration stretched the guidelines for Medicaid coverage to allow millions of working adults to qualify for the program.

It is unclear how many Medicaid recipients who are actively seeking work may lose their insurance in the process if their state should choose to enact the new guidelines.

"CMS recognizes that a broad range of social, economic, and behavioral factors can have a major impact on an individual's health and wellness, and a growing body of evidence suggests that targeting certain health determinants, including productive work and community engagement, may improve health outcomes", she wrote.

CMS Administrator Seema Verma said in her letter that employment and higher earnings are associated with improved mental health and overall wellbeing.

"[1115 demonstration] modifications may include counting time spent in medical treatment toward an individual's community engagement requirements or exempting individuals participating in intensive inpatient or outpatient medical treatment, as well as supporting other state efforts", CMS said. He dismissed the agency's justification that unemployment makes people less healthy.

Cuello said the argument that work promotes health is "totally contorted".

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