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Seema Verma, now administrator of the Centers for Medicare and Medicaid Services, guided her home state of Indiana to expand Medicaid eligibility under the governor at the time, Mike Pence, while emphasizing "personal responsibility." Credit Stephen Crowley / The New York Times
Seema Verma, now administrator of the Centers for Medicare and Medicaid Services, guided her home state of Indiana to expand Medicaid eligibility under the governor at the time, Mike Pence while emphasizing "personal responsibility." Credit Stephen…

Why the fuss with Medicaid’s work requirements?

While the country's big parties are fighting for funding in 2018 - putting thousands of immigrant lives at risk in the process - the Trump Administration has…

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In the Trump Era, being poor will be increasingly difficult, and the government takes advantage of media scandals to approve controversial measures without anyone finding out.

Such is the case of a normative guidance issued by the government during the past week in which states are allowed to impose labor requirements for Medicaid beneficiaries.

According to David A. Super, columnist for the Los Angeles Times, this is a new term that implies "time limits": "disqualifications for those whose job searches have failed to bear fruit, or ruses for running needy people through bureaucratic mazes until they miss a step and lose eligibility.”

As Super continues to explain, these types of strategies date back to the Clinton administration (when applied to the Supplemental Nutrition Assistance Program) but had remained an option at the discretion of each state - very few of whom chose to implement it.

The scenario is quite different now.

Although the system is the same (those who can’t find a job are directly disqualified from the assistance system), the new policy sponsored by the Republican Party will prove a measure never used before: the flexibility that was once known under the Obama Administration - that expanded Medicaid coverage to people in the 138% range of the federal poverty level - has been eliminated under the "characterization" that "the poor take advantage of the Medicaid system," as explained by The Hill.

This measure had been cooking since the first days of this Administration when some officials brought to light the possibility of authorizing the imposition at a national level. But last Friday it became a reality when the state of Kentucky received official approval from the government to implement what they have called "an overhaul of Medicaid".

On the other hand, there will be resistance. The Hill explains that, “under federal law, the Centers for Medicare and Medicaid Services (CMS) need to consider if a waiver is likely to assist in promoting the objectives of Medicaid,” and several lawyers and activists have seen this condition as an argument solid enough to reject the labor requirements since they “don’t promote the objectives of the Medicaid program because they would be a barrier to coverage.”

Faced with the possible rejection of the measure, CMS officials have ensured that the requirements will only apply to "able-bodied people", and that there will be exceptions for children, seniors, pregnant women and disabled people.

The Kentucky program will also incorporate exceptions for people with terminal illnesses or addictions.

While CMS administrator Seema Verma said this new mechanism would work as "stimulation for people to get jobs," several Kentucky officials said that by the end of 2018, 95,000 people might have lost medical coverage.

Still, deeply Republican states like Arizona, Arkansas, Indiana, Kansas, Maine, New Hampshire, North Carolina, Utah, and Wisconsin are beginning to apply for the exemption.

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