Adding work or service requirements for Medicaid will cut spending by throwing people off their health care. But in Kentucky, political operatives think the left will be disappointed.
The Centers for Medicare and Medicaid Services announced the approval on Friday. They estimated as many as 95,000 people could lose their Medicaid benefits, either because they did not comply with the new rules or they lose their eligibility when they get jobs that pay too much money. Currently, 80 percent of Medicaid beneficiaries work, and the vast majority of those who don’t are either ill, disabled, currently enrolled in school, or are working as unpaid caregivers.
ME showed the extent to which Americans value Medicaid – a program that has steadily grown in popularity, with over 60 percent of Americans saying it should continue unchanged – and are willing to vote for it. “It will be interesting to see how states are going to make this work for people”. “It will soon become the standard and the norm in the United States of America, and America will be better for it”.
The Louisiana Budget Project, which advocates for low- to moderate-income families, said many nonworking Medicaid recipients have circumstances that make it hard for them to work.
Leonardo Cuello, the director of health policy at the National Health Law Program, believes many of these provisions are subject to court challenges because they violate Congress’ original intent for Medicaid and do not meet the waiver law’s requirement that they consist of a novel policy experiment.
The proposed work requirement mandates only 20 hours of work per week for new enrollees; then 25 hours after receiving 12 months of benefits; and 30 hours after receiving 24 months of benefits.
Several of the states mulling a Medicaid work requirement are expected to be battlegrounds for statewide and congressional elections in November.
But the electoral dynamics in those states are very different than in Kentucky. Although he backed off that promise ― perhaps because many of those who supported him would have been among the hundreds of thousands losing coverage ― he has continued to suggest Medicaid needs radical changes because, he says, it encourages dependency.
Kentucky Governor Matt Bevin (R) is threatening to end Medicaid expansion for almost 500,000 people if the changes he made to the program are questioned in court. In addition, 52 percent of Medicaid beneficiaries that are able-bodied do not work. Between 1987 and 2015, spending per beneficiary grew by about 4 percent per year for Medicaid, compared to about 7 percent for private coverage. It is not a coincidence that states that expanded Medicaid have also reduced the unmet need for treatment of substance abuse disorders by 18 percent. That’s far from certain. This is resulting in reduced health care costs for both employers and employees. By the end of 2016, the state was tied with West Virginia for the biggest percentage increase in health coverage. “And for those who are eligible for an exemption, the policy could still require someone who is medically frail, for example, to jump through administrative hoops to demonstrate that they are eligible for an exemption”. Loomis added who added that imposing the work requirement could backfire in a state where many support expanding Medicaid eligibility under the Affordable Care Act.
Another Kaiser study found that most working-age adults on Medicaid are already employed. Another 28 percent are caretakers. The ACA’s Medicaid expansion has allowed many women to maintain continuous access to primary care and family planning services before and after pregnancy, and to avoid unintended pregnancy. Mandatory work requirements are meant to reduce access to coverage, and therefore, the Trump administration is likely to be defending this policy in court sometime soon.
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