Kentucky Became the First State to Implement Work Requirements for Medicaid

The federal Centers for Medicare and Medicaid Services made the announcement Thursday.

Yesterday, health care advocates in North Carolina and across the USA were officially alerted to yet another fight to ensure that people retain health coverage and access to care.

Although the work requirements might be flexible, some Americans could have trouble showing they’re exempt if, for example, they can’t show a diagnosed disability.

The Bluegrass State thus becomes the first state to act on the Trump administration’s unprecedented change that could affect millions of low-income people receiving benefits.

The requirement, modeled after the work requirement for the state’s food stamps program, would initially apply to enrollees ages 30-49 and would then be extended to those ages 19-29.

Researchers examined the proportion of pediatricians accepting Medicaid before and after payments increased in 2013 and 2014 – and found gains in participation nationwide as well as in most studied states.

“State and local officials know much better than the federal government how best to care for their citizens in need”, said CMS Administrator Seema Verma. Her agency spelled out safeguards that states should put in place to get federal approval for their waivers. Under state work requirements, people have to verify their work status or their qualification for an exemption, according to, associate director of Kaiser Family Foundation’s Program on Medicaid & the Uninsured.

[CMS] encourages states to consider a range of activities that could satisfy work and community- engagement requirements. The states are Arizona, Indiana, Kansas, Maine, New Hampshire, North Carolina, Utah and Wisconsin.

The Southern Poverty Law Center also has condemned the new Medicaid guidelines from the Trump administration as a step backward for public health.

Bevin has said that the system can not continue as it has because it costs too much, ignores private market dynamics and fails to prepare Kentuckians for self-sufficiency.

“Make no mistake: People will die because of this”, Rep. John Yarmuth, D-Ky., said in a statement.

Democratic groups are expected to sue over the changes, arguing that the administration does not have the power to make them without action from Congress.

Dustin Pugel, policy analyst with the Kentucky Center for Economic Policy, said Friday the change will reverse “the historic progress” Kentucky made in health care over the past two years. And Virginia House and Senate Democrats announced Thursday that Medicaid expansion is their top goal for this legislative session.

The debate about work requirements doesn’t break neatly along liberal-conservative lines.

The Kentucky program also imposes a premium on most Medicaid recipients based on income. Almost 60 percent work either full time or part time, mainly for employers that don’t offer health insurance. Most of those who don’t work cite illness, disability or family obligations as the reason.

According to Governor LePage healthy adults who can contribute by either working or volunteering should do so and that will help people break the cycle of poverty.

—Exempting pregnant women, disabled people and the elderly. For instance, time spent in medical treatment may count toward community engagement time, while those in intensive treatment may be exempt.

“The truth is, people are going to lose Medicaid coverage”, he said. Therefore, they should meet the state’s new work requirements.

ME is one of ten states asking for a waiver from the Federal Department of Health and Human Services.

They estimate the changes will save about $2.4 billion over five years. The administration says the impact will be closely evaluated. So is he really going to make welfare recipients work?