"Those days are over".
Verma insisted the Trump administration wants to give states leeway to make its own decisions and try out their own ideas. The remaining 60% of non-SSI Medicaid adults who either work part-time or full-time; presumably would meet any work requirement policy. Work requirements played a major role in driving that decline.
Medicaid, an important social safety net program created five decades ago and expanded under Republican President Donald Trump's Democratic predecessor Barack Obama, has never had such conditions attached.
"They want to push people off medicaid and... give states... the option to tell people that you can't be on Medicaid because you're not working", Gerisch said. The memo cites studies indicating higher earnings are tied to longer lifespans, whereas unemployment is tied to higher mortality rates.
We see moving people off Medicaid as a good outcome because that means they do not need the program anymore and have transitioned to a job or can afford insurance, she said.
The state's Medicaid program, which is called the Arizona Health Care Cost Containment System or AHCCCS, submitted its final application on December 19 to the federal government's Center for Medicare and Medicaid Services.
Though participating in such activities would theoretically ensure their continued Medicaid benefits, Waligora worries that failure to comply with "onerous administrative requirements" could cause even those who are eligible to lose coverage.
The change was the most popular among potential changes to Medicaid, including requiring beneficiaries to undergo drug tests (64 percent).
Wisconsin's proposal, which applies to able-bodied adults without children, seeks to limit a person's eligibility for Medicaid to 48 months unless they can show they have been working at least 80 hours a month.
-Allowing people under treatment for substance abuse to have their care counted as "community engagement" for purposes of meeting a requirement.
The Trump administration said that state Medicaid officials could not impose work requirements on pregnant women, elderly beneficiaries, children or people who were unable to work because of a disability.
Platt also is concerned about patients who've been incarcerated.
The new policy would be attempting to solve a problem that doesn't exist.
The new guidance allows states to apply for waivers, something that has never happened in Medicaid's 50-year history.
The new policy guidance provides design support for state 1115 demonstrations looking to add flexible work requirements consistent with standard federal Medicaid rules.
Verma does not specifically state that those who don't work will be cut off from Medicaid coverage, but Twitter Thursday lit up with accusations of cutting off "frail" enrollees while others applauded the initiative to get people "on the dole" back to work.
But the new policy is exactly what some Republican governors were seeking.
Work requirements also are opposed by the Illinois Health and Hospital Association, which advocates for more than 200 hospitals and almost 50 health systems in the state.
"We believe that this guidance is illegal", she said. The main impact of the rules will be to subject poor people to paperwork that will drive some to drop coverage, the critics say. "There's a sense of pride that comes with having a job to do and being able to provide for your family". Opposing work requirements for able-bodied beneficiaries, she said, was "soft bigotry" on the part of the Obama administration, which hadn't approved a waiver Verma helped design in IN which originally contained such a provision.
CMS also advised states to make work requirements for Medicaid similar than those used with food stamps to reduce the burden on both states and beneficiaries..
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