ACP ‘strongly opposes’ enforcing work requirements for Medicaid

ACP emphasized its strong opposition to restricting access to health care coverage through Medicaid based on employment status.

The Trump administration announced yesterday that it would allow states to attach work requirements to “able-bodied adults” who applied for benefits based on the requests of 10 states - Arizona, Arkansas, Indiana, Kansas, Kentucky, Maine, New Hampshire, North Carolina, Utah and Wisconsin. The requirements would not apply to Medicaid recipients not of working-age, or who were pregnant or received Medicaid benefits on the basis of a disability.

“Our policy guidance was in response to states that asked us for the flexibility they need to improve their programs and to help people in achieving greater well-being and self-sufficiency,” Seema Verma, CMS Administrator, said in a press release.

Before being appointed to run CMS, Verma worked as a consultant for several states on Medicaid reform, including Indiana and Kentucky.

“Medicaid was designed as a health care program, to provide vulnerable members of our society with access to care they badly need,” Jack Ende, MD, president of ACP, said in a press release. “Work requirements impose an additional, unnecessary barrier to allowing patients access to vital health care services for people who need access and coverage the most.”

According to a study by the Kaiser Family Foundation, 80% of individuals enrolled in Medicaid are in working families or are working themselves; however, most of the adult Medicaid enrollees who were not working reported not being able to work due to major impediments, the ACP said in the release. Specifically, the main reason more than one-third of enrollees were not working was because of illness or disability. Among adult non-SSI nonworking Medicaid enrollees, 88% reported having a functional limitation and 67% reported having two or more chronic conditions, such as arthritis or asthma.

Other reasons for not working included taking care of home or family (30%), being in school (15%), searching for employment (6%) and retirement (9%). In 2016, 62% of nonworking Medicaid enrollees were women and 17% were parents with children aged 6 years or younger.

ACP noted that offering individuals assistance in finding employment through skills- and interview-training should be made available, but not required for Medicaid eligibility.

“Medicaid is a critical piece of our country’s health care system,” Ende said. “We need to work together to find ways to improve the program, instead of restrict it, so that it better provides health care coverage to those who need it.”