States Ask Feds to Approve Work Requirements for Medicaid

Published June 28, 2017

Multiple states have asked the federal government to approve Medicaid reforms that would reduce the number of nonworking able-bodied enrollees, and several other states are considering making similar requests.

A new Arkansas law requires the state’s Department of Health and Human Services to ask the federal Centers for Medicare and Medicaid Services (CMS) to approve changes such as work requirements and capping enrollment eligibility at 100 percent of the federal poverty level, Health Care News reported in July.

Wisconsin has asked CMS to approve requiring able-bodied Medicaid participants to pass a drug test. Individuals who fail the test would be ineligible for the program until they enter a treatment program, The MacIver Institute reported on June 8.

Indiana has proposed requiring certain able-bodied Medicaid recipients to work or pursue job training, according to an amendment to Healthy Indiana Plan 2.0 submitted to CMS on May 24.

Officials in Arizona, Florida, Maine, and Ohio have considered making similar proposals in 2017. Kentucky submitted a work requirements proposal to CMS in August 2016.

Working for Ohio

Ohio state Rep. Wesley Goodman (R-Cardington) says proponents of Medicaid reform believe work requirements would help strengthen families.

“We believe strongly that there is dignity and purpose in work,” Goodman said. “While detractors often equate work requirements with punishment, we know that the meaning and significance found in work and acts of provision are just as necessary for the health of individuals and families as the care provided through the Medicaid program.”

The current system traps enrollees because it lacks incentives for people to become self-sufficient, Goodman says.

“In the ever-changing 21st century economy, we do incredible harm to our most vulnerable citizens by putting them in a public program that does not empower them to be successful beyond their time of need,” Goodman said. “Rather than treating those in need as victims and clients of an ever-growing welfare state, it is critical that we view them and treat them as free and equal American citizens.”

Kentucky Considers Indiana Example

Kentucky Gov. Matt Bevin (R) submitted a waiver to CMS for Kentucky HEALTH in August 2016. If approved, the program would require “all able-bodied working age adult members without dependents” to work, undergo job training, or perform volunteer community service, the waiver application states.

Kentucky state Sen. Ralph Alvarado (R-Winchester) says the Kentucky HEALTH waiver is based on Indiana’s Medicaid program.

“One of the programs that I thought was working for Medicaid was Indiana’s model,” Alvarado said. “When Gov. Bevin got elected, I remember talking to him about that model. And he appeared to already be versed in it, thanks to then-Gov. [Mike] Pence, who taught him how to restructure Medicaid.”

The Kentucky HEALTH model would give able-bodied Medicaid enrollees ample time to start working, training, or volunteering, Alvarado says.

“It has to be an innovative approach, and [Bevin] put in the volunteering and workforce approach,” Alvarado said. “This says that if you are an able-bodied adult and you’re on the Medicaid system, we’re going to give you three months. If you don’t have another job in three months, then go and get an education and go to school, or you have to be volunteering in your community.”

Michael McGrady ([email protected]) writes from Colorado Springs, Colorado.

Internet Info:

Arianna Wilkerson, “Arkansas Seeks Feds’ Approval to Roll Back Medicaid Expansion, Adopt Work Requirements,” Health Care News, The Heartland Institute, June 5, 2017:

Matthew Glans, “States Pursue Work Requirements for Medicaid,” Research & Commentary, The Heartland Institute, June 1, 2017:–commentary-states-pursue-work-requirements-for-medicaid

“Kentucky Health Medicaid Reform Proposal,” Office of the Governor, June 22, 2016:

Official Connections:

Ohio state Rep. Wesley Goodman (R-Cardington):

Kentucky state Sen. Ralph Alvarado (R-Winchester):

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