Work Requirements May Be Just the Beginning of Medicaid Changes Under Trump

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But the reality is that Medicaid, like most federal and state welfare programs, has gotten so out of control and strayed so far from its original goal that imposing work requirements on able-bodied adults will actually help enrollees far more than Medicaid coverage will, mostly by giving them a strong incentive to secure full employment. And we could see some results pretty soon 'cause there are rumors swirling that by tomorrow, Kentucky's application could possibly be approved. Trump's decision can be reversed by a future administration, however, so we just have to survive the next three years, if that.

A clearly pleased Bevin went so far as to describe the approval as a first step in "entitlement reform" which he claims will become a model for the nation.

Administration officials call that "community engagement" a key component of the program they've named Kentucky HEALTH. "What we are doing is providing targeted supports that will help qualified Apple Health clients to maintain housing and jobs-and ultimately self-sufficiency".

Most Republicans, including U.S. Senate Majority Leader Mitch McConnell, R-Ky., hailed the announcement while Democrats bewailed it.

"Kentucky HEALTH is specifically tailored with the unique needs of Kentuckians in mind". Although waivers can have lasting impact they don't amount to a permanent change in the program.

It's a "large and sharp reversal" from Medicaid in the past, says Judith Solomon, vice president of health policy at the Center on Budget and Policy Priorities.

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Bevin, a fierce opponent of ObamaCare, was elected in 2016 partly on a promise to change the state's expansion of Medicaid that came as part of the law. Steve Beshear, the expansion allowed 475,000 Kentuckians to gain Medicaid.

In order to qualify for Medicaid in MS as a low-income caretaker, a person with one dependent can not receive more than $306 per month in income. These programs require the federal government to grant so-called Section 1115 [text] waivers, based on whether the "experimental, pilot, or demonstration project [.] is likely to assist in promoting the objectives" of the Medicaid program more broadly.

"It is not a matter of charity to extend health care to people who do not have access to health care".

Under Kentucky HEALTH, enrollees will make a monthly payment ranging from $1 to $15 depending on income. "It will actually help this population reap the rewards of a good job, and one day receive health care coverage from their employer, not the state or federal government", Bryant said. Or, as he said on Friday, the waiver will give enrollees "the dignity associated with being able to earn the things they are receiving". A Kaiser Family Foundation analysis a year ago found that most of the 10 million Medicaid enrolled adults had legitimate excuses for not working with only 6 percent unemployed because they could not find a job. The letter states that the program seeks to teach beneficiaries to transition to commercial insurance by requiring them to pay premiums, using periods of ineligibility if premiums are not paid, and using limited enrollment windows. Many others - poor children, people with disabilities - obtain insurance from programs whose premise is that the recipients are neither expected nor able to work, which is itself a work-related criterion. Bevin said he expects the program to be fully implemented at the beginning of next year.

The move - which came just a day after administration officials announced the new guidance - is widely expected to pave the way for several other states, nearly all with with Republican governments, to incorporate work mandates into their Medicaid plans.

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