Kentucky becomes the first state allowed to impose Medicaid work requirement

US moves to limit Medicare the publicly funded health insurance program for the poor and disabled have been the subject of protests like this one in July,2017 in New York City

Kentucky Is the First State to Enact Medicaid Work Requirements

Before coming to Washington previous year, Verma was a health consultant who worked with IN and Kentucky to expand Medicaid under the ACA.

Bevin said the waiver will be "transformational".

"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".

Under Bevin's Democratic predecessor, Gov. Steve Beshear, Kentucky embraced Medicaid expansion and was viewed as a national model for its implementation of the ACA.

The approval comes 16 months after Bevin, a Republican elected in 2015, announced sweeping changes to the $10 billion federal-state program that provides health care for 1.4 million low-income and disabled Kentuckians, arguing it is "not sustainable".

"This is not an option we are considering", said Jennifer Kent, director of the state Department of Health Care Services, which administers Medi-Cal, the state's Medicaid program that covers about 13.5 million Californians.

A study found the proposal would reduce the number of residents on Medicaid by almost 86,000 within five years, saving more than $330 million. In the past, federal officials said work was not among those objectives. Federal officials are now encouraging states to consider work or community involvement requirements for able-bodied Medicaid recipients, a key part of the New Hampshire approach to the federally funded health insurance program for low-income households. Anyway, it's one of those "damn straight" type ideas that politicians often say they believe, but never actually do because it's not that simple, or because there's too much resistance, or. well, or because they never really meant to do it in the first place.

Former governor Steve Beshear originally expanded Kentucky's Medicaid program to include people making up to 138 percent of the poverty limit after the Affordable Care Act passed in 2010, setting up a funding stream for states to expand the program for low-income Americans.

California health care leaders dismissed the idea of imposing a work requirement on the state's Medicaid enrollees, saying it would never come to pass. "It's not about employment encouragement". They include a new system that will require some people in the program to make small monthly premium payments, incentives to adopt healthy behaviors and different benefits provided to certain groups. But the changes also would make it harder for people to keep their Medicaid coverage. The requirement doesn't apply to those with disabilities, the pregnant, or the elderly. The letter released Thursday by CMS contains similar language on the work requirements.

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Ragbir came to America from Trinidad in February 1991 on a visitor's visa and became a green card holder in 1994. ICE justified its decision and said he will remain in custody pending removal to Trinidad.

Medicaid is one of the largest expenses from the state's General Fund, with $8.4 billion of almost $32 billion in state spending paying for the program. That Medicaid expansion was sharply criticized by conservatives, and Republicans in Congress tried to add work requirements in their unsuccessful bid past year to overturn the health law. After that, their benefits will cease until they prove they have begun following the rules.

President Donald Trump listens to Seema Verma, administrator of the Centers for Medicare and Medicaid Service, during a healthcare panel in the Roosevelt Room at the White House on March 22, 2017.

The state projects significant cost reductions, largely because growing numbers of poor Kentuckians will be caught up in the complex reporting requirements and paperwork, causing them to lose coverage. The work requirements will likely be challenged in court.

"They're going to try to force a square peg into a round hole", he said.

Bevin first pledged to undo his state's expansion of Medicaid, which had helped cause the ranks of uninsured Kentuckians to dwindle more than in nearly any other state.

States are still awaiting formal approval of their requests. "We look forward to reviewing the outcomes from Kentucky's thoughtfully-crafted, groundbreaking demonstration, which will undoubtedly aid Medicaid reform efforts across our nation". States should take these issues - as well as recipients' employability - into consideration and allow for modifications or exemptions, the agency said.

But Bevin said Friday the community engagement feature will allow Kentuckians on Medicaid "the respect and dignity to do something for themselves".

This Kaiser Health News story can be republished for free (details).

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