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No work, no Medicaid? Illinois reviews new federal guidelines

14 Janvier 2018

Mandating work requirements has been a long-standing priority for conservatives, and the Trump administration announcement reverses previous policies that prevented states from requiring Medicaid beneficiaries to work to qualify for the program.

The Centers for Medicare and Medicaid Services has issued a new rule that makes it possible for states to require Medicaid recipients to work, or undergo job training, in order to receive benefits.

Medicaid, unlike cash welfare payments, isn't a disincentive to work, because it doesn't provide people with funds they'd need to pay rent or buy food, said Jeff Grogger, an urban policy professor at the University of Chicago. Under our proposal, people who receive Medicaid and are able bodied will need to work, be training for a new career, or volunteer.

The state's Medicaid department is already in the process of applying for a waiver to add work requirements, which was part of the budget passed past year. They will be exempt from the new requirements.

ME also wants to remove "retroactive eligibility" that permits those eligible for Medicaid to get coverage for conditions that occurred up to three months before enrolling in Medicaid.

Federal officials said Thursday that it would be a good sign if people left Medicaid for private coverage offered by employers.

Since congressional Democrats can not stop the administration from issuing waivers, this battle now moves to the states. "It would only apply to the ten or so states run by far-right Republicans who have asked to do this".

A study from the non-partisan Kaiser Family Foundation found that nearly 60% of working-age adults on Medicaid are already employed.

Wisconsin is evaluating how the new policy will affect its proposal, which is meant to "help more people move from government dependence to true independence by encouraging work and providing incentives for healthy lifestyles", said Elizabeth Goodsitt, spokeswoman for the Wisconsin Department of Health Services.

Certain Medicaid recipients would be exempt from the rules, including those with disabilities, the elderly, children and pregnant women, the administration said.

"Should eligible Medicaid recipients be looking for work or be trying to work?"

"States. want more flexibility to engage their working-age, able-bodied citizens on Medicaid", Verma told a gathering of state Medicaid directors in November.

Republicans have been pushing for the change since the Affordable Care Act added millions of “able-bodied” adults to Medicaid. Alker says that seems like a good thing, though the "cynic" in her worries it's created to keep the question of how many people will lose Medicaid "even more in the dark".

A survey Kaiser conducted previous year said those who weren't working said it was because of an illness or disability, home or family responsibilities, pursuit of an education, retirement or inability to find a job. The program will be similar to requirements imposed on recipients of the Supplemental Nutrition Assistance Program (SNAP) and Temporary Assistance for Needy Families (TANF). One 2006 study found that going back to work can even "reverse the negative health effects of unemployment", CMS said. But as these CMS bureaucrats are well aware, as a result of these policies, increasing numbers of workers and sick people will be stripped of their health benefits and be plunged deeper into poverty. It is likely to prompt a lawsuit from patient advocacy groups, which claim the requirement is inconsistent with Medicaids objectives and would require an act of Congress. "They are just working inconsistent hours or their hours fluctuate a lot", Mr. Pugel said.

It's more common for Medicaid enrollees to hold jobs if they live in states that expanded Medicaid under Obamacare.

"The other thing [that was mentioned was] that people are less depressed when they have money, well yeah, people that are on Medicaid are frequently depressed, I would imagine so", the activist said.

The revised website content signals a new, broader view of these demonstrations in which states can focus on evidence-based approaches that drive better health outcomes, and quality of life improvements, and support upward mobility and self-sufficiency. Additionally, the guidance details that states can not accrue savings from loss in enrollment due to work requirements, which means that states will need to pay for any work requirement administrative burden, such as determining if an individual is working, developing an enrollee reporting system and employment supportive services, etc.

No work, no Medicaid? Illinois reviews new federal guidelines