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Trump administration pushes for wasteful, ineffective work requirements in Medicaid

14 January 2018, 12:35 | Myrtle Vega

Kentucky Gov. Matt Bevin left and President Trump during a prison reform roundtable on Thursday

Kentucky Gov. Matt Bevin left and President Trump during a prison reform roundtable on Thursday

The state, along with the rest of Appalachia, falls behind the rest of the U.S.in 33 out of 41 population health indicators, according to a recent study. The difference this time around is that the federal government will recognize it.

"Given the potential benefits of work and community engagement, we believe that Medicaid programs should be able to support these activities and test incentives that are appropriate for this population and lead to improved health outcomes", the agency wrote. The requirement doesn't apply to those with disabilities, the pregnant, or the elderly. "It is a basic moral law and act of human decency", said Imam Ammar Amonette of the Islamic Center of Virginia. But a Kaiser Family Foundation analysis released last month showed a majority - 60 percent - of adults enrolled in Medicaid were working. Of those who aren't working, many have care-giving responsibilities that either they would have to abandon or states would have to accept as the equivalent of work outside the home, after a lot of complex and expensive administrative hassle.

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. The federal Centers for Medicare and Medicaid Services made the announcement Thursday. In the past, federal officials said work was not among those objectives.

Some researchers suggest that if the income of an individual is boosted, their health will improve.

Throughout the entire half-century history of Medicaid, created to provide health care to low-income individuals, benefits have never been contingent upon applicants working.

Administration officials call that "community engagement" a key component of the program they've named Kentucky HEALTH.

The Trump administration said states imposing work requirements must have plans to help people meet those requirements and should help arrange job training, child care and transportation as needed.

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The state's previous Democratic governor Steve Beshear expanded Medicaid eligibility under ObamaCare to people earning up to 138 percent of the federal poverty level.

Pugel previously had told Insider that many people who will lose coverage have chronic illnesses that will go untreated until the severity of their conditions brings them to local emergency rooms, where they will receive expensive care that will be paid either by the hospitals through charity care - or by people with insurance who pay higher rates than they normally would.

Democratic Gov. Tom Wolf vetoed a work-search requirement passed past year by the Republican-controlled state Legislature. "So the potential for work in our neighborhood without having to take a bus significant distance and time out of the neighborhood is going to be a challenge", she said.

There's also concern that work requirements in a state like Kentucky, which has been hit hard by the opioid epidemic, might be a barrier for people seeking addiction treatment.

In fact, similar work requirements for the federal nutrition program SNAP have proved so burdensome that states often prefer not to implement them just to avoid the hassle, according to from the Agriculture Department's Office of the Inspector General. It also encourages an exemption for people who are deemed "medically frail".

Rep. Frank Pallone, D-N.J., said "the Trump administration's action today is cruel and a clear violation of both the Medicaid statute and long-standing congressional intent" for waivers, which he said were meant to "allow states to expand access to Medicaid, not restrict it".

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