Archive for Thursday, January 11, 2018

Trump creates path for Kansas, other states to require Medicaid recipients to have a job

January 11, 2018


WASHINGTON (AP) — In a major policy shift that could affect millions of low-income people, the Trump administration said Thursday it is offering a path for states that want to seek work requirements on Medicaid recipients.

Kansas is one of several states that have filed a federal request seeking to add a work requirement to its Medicaid program.

Seema Verma, head of the Centers for Medicare and Medicaid Services, said work and community involvement can make a positive difference in people's lives and in their health. Still, the plan probably will face strong political opposition and even legal challenges over concerns people would lose coverage.

Medicaid is a federal-state collaboration covering more than 70 million people, or about 1 in 5 Americans, and that makes it the largest government health insurance program. It was expanded under President Barack Obama, with an option that has allowed states to cover millions more low-income adults; many have jobs that don't provide health insurance.

People are not legally required to hold a job to be on Medicaid, but states traditionally can seek federal waivers to test new ideas for the program.

The administration's latest action spells out safeguards that states should consider to obtain federal approval for waivers imposing work requirements on "able-bodied" adults. Technically, those waivers would be "demonstration projects." In practical terms, they would represent new requirements for beneficiaries in those states.

The administration said 10 states — mostly conservative ones — have applied for waivers involving work requirements or community involvement. They are: Arizona, Arkansas, Indiana, Kansas, Kentucky, Maine, New Hampshire, North Carolina, Utah and Wisconsin. Advocates for low-income people say they expect Kentucky's waiver to be approved shortly.

"Medicaid needs to be more flexible so that states can best address the needs of this population," Verma said in a statement. "Our fundamental goal is to make a positive and lasting difference in the health and wellness of our beneficiaries." For close to a year, the administration has signaled an interest in helping states that want to institute work requirements.

Advocates for low-income people said work has never been a requirement for Medicaid, a program originally intended as a health program for the poor and disabled. It now covers a broad cross-section of people, from many newborns to elderly nursing home residents, and increasingly working adults.

"It is a very major change in Medicaid that for the first time would allow people to be cut off for not meeting a work requirement, regardless of the hardship they may suffer," said Judy Solomon of the Center on Budget and Policy Priorities, which advocates for the poor. The Obama administration would have never approved such waivers, she added.

A study from the nonpartisan Kaiser Family Foundation found that a surprising number of working-age adults on Medicaid are already employed. Nearly 60 percent work either full time or part time, mainly for employers that don't offer health insurance. Most who are not working report reasons such as illness, caring for a family member or going to school. Some Medicaid recipients say the coverage has enabled them to get healthy enough to return to work.

The debate about work requirements doesn't break neatly along liberal-conservative lines. Kaiser polling last year found that 70 percent of the public support allowing states to impose work requirements on Medicaid recipients, even as most people in the U.S. were against deep Medicaid cuts sought by congressional Republicans and the Trump administration.

Thursday's administration guidance to states spells out safeguards that states should consider in seeking work requirements. These include:

—exempting pregnant women, disabled people and the elderly.

—taking into account hardships for people in areas with high employment, or for people caring for children or elderly relatives.

—allowing people under treatment for substance abuse problems to have their care counted as "community engagement" for purposes of meeting a requirement.

The administration said states must fully comply with federal disability and civil rights laws, to accommodate disabled people and prevent those who are medically frail from being denied coverage. States should try to align their Medicaid work requirements with similar conditions applying in other programs, such as food stamps.

"People who participate in activities that increase their education and training are more likely to find sustainable employment, have higher earnings, a better quality of life, and, studies have shown, improved health outcomes," Verma said.

Solomon, the advocate for low-income people, said the federal government's waiver authority doesn't provide carte blanche to ignore the basic purposes of the program, and promoting work has not been on that list up to now.

"There's never been a work requirement in Medicaid, it's only been in recent years that states have raised the possibility of having one," she said. "Medicaid is a health program that is supposed to serve people who don't otherwise have coverage."


Pete Rowland 2 months, 1 week ago

no problem with work requirement for able-bodied adults who don't meet the safeguard exceptions, but it is mostly symbolic chest pounding. Two questions. First, does anyone think these able-bodied folks are going to find jobs with health insurance or a wage that enables them to buy health insurance rather than rely on Medicare? Second, and most important, when are we going to recognize that -- per the 60% of recipients who are already employed -- the Medicare Program is essentially a huge subsidy for low-wage employers like McDonalds et al -- a subsidy paid for by the rest of us?

Greg Cooper 2 months, 1 week ago

Pete, are you confusing Medicare (older people) with Medicaid (any age with disabilities unable to afford any health care)? Other than that, I agree wholeheartedly with you.

P Allen Macfarlane 2 months, 1 week ago

Considering the perception among some Christians that folks on Medicaid are lazy and don't want to work, I'd say the actions taken by Trump's administration are nothing new. and as far as subsidies are concerned, why are we not also complaining about all the subsidies we give the rich and the corporations in terms of tax breaks and what about those subsidies for farmers? I don't see any so-called conservatives complaining about those.

Armen Kurdian 2 months, 1 week ago

A lot of conservatives complain about that, and we can do w/o the Christian bashing.

Steve Hicks 2 months, 1 week ago

Allen, don't confuse the deluded "Christian conservative" faction with Christians.

Christians don't.

Dorothy Hoyt-Reed 2 months, 1 week ago

I've started just using the term evangelical, not Christian.

Bob Summers 2 months, 1 week ago

I've started just using the term congenital Liberal, not loon.

Kathleen Christian 2 months, 1 week ago

I find your comment about Christians offensive and ignorant. Not all Christians think this way, in fact I would venture to say most do not think this way. How can you say that when you have no idea what a Christian (who believes in Jesus Christ) really thinks, since you sound as if you are not a believer. Your comment is the same as saying that all Doctors know how to cure cancer, because they studied medicine. Read your Bible and find a Bible teaching Church and perhaps your perspective may change. I'll pray for you P. Allen Macfarlane.

Greg Cooper 2 months, 1 week ago

So, you guys who worship actors are upset by the words of an actor? De Niro doesn't speak for me or you, but for himself. And I could come up with tons of stupid s--- that Chump has uttered, including his racist, potty-mouth statement just today. But you'll defend him, or, better yet, accuse him of being a congenital liberal because you have nothing to add to the discussion due to your complete lack of conviction as to how things would be run. You've been challenged, time and time again, to come up with a reasonable thought but all you can throw out is your illiterate construction of a study that shows nothing close to what you apparently believe.

Smile at that, Bob, and go on with your empty political life. You have nothing to say that interests intelligent people.

Bob Summers 2 months, 1 week ago

De Niro is a congenital Liberal.

You are missing the affect the gene has on people.

De Niro is under the influence of the genetic condition.

He speaks of Trump like Liberals in cobalt blue Larryville do.

Greg Cooper 2 months, 1 week ago

Kathleen, you are missing the point. Christians don't act or speak as the "evangelicals" who were in large part responsible for Chump's election. Christians have compassion for all people, no matter what. What they do not do, as the evangelicals would have you believe, is disregard lawlessness, sin, economic need, race, gender, lifestyle (including sexual differences), age or anything else other than that people are all equal in the eyes of God and should have equal opportunity to live, unfettered by artificial barriers. Christians do not judge others but try to help others live by the rules laid out by God and do not make up artificial, self-serving reasons that denigrate or otherwise deny full person-hood to others, no matter who they are. But you know all this, Kathleen: otherwise you'd not call yourself a Christian.

Dorothy Hoyt-Reed 2 months, 1 week ago

I see a lot of evangelicals who do not follow the Bible. They worship money. They are hateful people. They will act holier than thou, then commit adultery, lie, and steal. That being said, there are a lot of wonderful Christians out there who follow what Jesus taught. But they don't get in the news, do they? They don't get involved in politics. They don't declare their hatred of people who aren't like them. They don't call to hate people of other religions. These sects have TV shows with rich "preachers" who live in mansions and have private jets.

Now tell me. Do you consider Paula White a Christian? Did you send her your January wages?

Bob Summers 2 months, 1 week ago

What's the matter with this Trump character?

If Trespasser's and their offspring get sanctuary from the law and free healthcare, monetary bennies etc., why do citizens have to work for medicare?

If Trespasser's vote is that important, I'll vote Liberal for free stuff too! Gimme sanctuary from the law also.

Dennis Domer 2 months, 1 week ago


You are not making any sense again. You are much smarter than this.


Dorothy Hoyt-Reed 2 months, 1 week ago

" You are much smarter than this." You must be new here.

Dorothy Hoyt-Reed 2 months, 1 week ago

They are going to spend a lot of money to implement this and find out that the large majority either fit into the exemptions or already work. But, hey, some crony will get a six figure job to "manage" the program. And will the expand it to include people who are working, but can't get insurance?

Daniel Kennamore 2 months, 1 week ago

It'll be just like the drug testing requirements a few years ago. They'll spend 10x trying to administrate the new rules than they save by kicking offenders off the rolls

Tony Peterson 2 months, 1 week ago

The exemptions listed are pretty much all the requirements to even be eligible for Medicaid. This is just another Trump-ism from someone who has no clue what Medicaid is about.

Richard Heckler 2 months, 1 week ago

Medicare is a fine insurance service because it pays 80% whereas many insured by the insurance industry don't have it so well thus leaving the under insured vulnerable to bankruptcy thus needing more in social services.

ALEC Conservatives are not too smart and reckless managers of finances.

Richard Heckler 2 months, 1 week ago

When state legislators across the nation introduce similar or identical bills designed to boost corporate power and profits, reduce workers rights, limit corporate accountability for pollution, or restrict voting, odds are good that the legislation was not written by a state lawmaker but by corporate lobbyists working through the American Legislative Exchange Council.

ALEC is a one-stop shop for corporations looking to identify friendly state legislators and work with them to get special-interest legislation introduced.

It’s a win-win for corporations, their lobbyists, and right-wing legislators. But the big losers are citizens whose rights and interests are sold off to the highest bidder.

The American Legislative Exchange Council (ALEC) was founded in 1973 by Henry Hyde, Lou Barnett, and Paul Weyrich, who helped build a nationwide right-wing political infrastructure following the reelection of Richard Nixon.1 In the same year, Weyrich helped establish the Heritage Foundation, now one of the most prominent right-wing policy institutes in the country.

One year later, he founded the Committee for the Survival of a Free Congress, the predecessor of the Free Congress Foundation. In 1979, he co-founded and coined the Moral Majority with Jerry Falwell, and in 1981 he helped establish the ultraconservative Council on National Policy.

Richard Heckler 2 months, 1 week ago

ALEC serves as a means for corporations to advise, lobby and sway legislators. By paying hefty dues and sponsorship fees, corporations are able to participate in ALEC ventures, forums and legislative advocacy work, and also underwrite conferences, task forces and meetings with politicians.

Corporations use ALEC to formulate, present and promote model legislation to elected officials who are ALEC members, and hold leadership roles in the organization.

“Our members join for the purpose of having a seat at the table. That’s just what we do, that’s the service we offer,” explains Dennis Bartlett, an ALEC task force head who is also the executive director of the American Bail Coalition. “

The organization is supported by money from the corporate sector, and, by paying to be members, corporations are allowed the opportunity to sit down at the table and discuss the issues that they have an interest in.”12

ALEC propagates a wide range of “model legislation” that seeks to make it more difficult for people to hold corporations accountable in court; gut the rights and protections of workers and consumers; encumber health care reform; privatize and weaken the public education system; provide business tax cuts and corporate welfare; privatize and cut public services; erode regulations and environmental laws; create unnecessary voter ID requirements; endorse Citizens United; diminish campaign finance reform; and permit greater corporate influence in elections.

Bob Summers 2 months, 1 week ago

ALEC is needed to combat congenital Liberals from forcing a society to it's knees like the Liberal has done in places like Detroit or Venezuela.

Fred Whitehead Jr. 2 months, 1 week ago

What else would you expect from the racist, bigoted, s--t head jerk that the electoral college has brought on this country?

Bob Smith 2 months, 1 week ago

I see that Fred's bile is flowing again.

Michael Kort 2 months, 1 week ago


Who was president when " welfare to work" was signed into law, keeping one of his campaign promises ?

Clue, wasn't Obama or Baby Bush.......,so who could it be ?

Michael Kort 2 months, 1 week ago

Meanwhile we will have legislation going thru Topeka without any manes of any legislator on it which, will be voice voted, so that no voting records exist for reviewing by voters who elect ? .........BECAUSE CONGENITAL CON....... SERVATIVES are like like roaches......The darkness of names that are unrecorded and voice votes emboldens them .

David Holroyd 2 months, 1 week ago

How old can someone be and be on Medicaid?

just asking

William Cummings 2 months, 1 week ago

There is no age limit. Medicaid picks up the cost of skilled nursing after the 100 day limit on care provided by Medicare runs out, for patients with limited or no resources. Medicaid can also pick up some of the out of pocket expenses, including premiums, again, for medicare recipients with limited incomes. Prescriptions and other services provided by both are first paid by Medicare up to applicable limits, and then by Medicaid up to the state limit.

Bob Smith 2 months, 1 week ago

Meanwhile, in California: "...It’s not as though California policymakers have neglected to wage war on poverty. Sacramento and local governments have spent massive amounts in the cause. Several state and municipal benefit programs overlap with one another; in some cases, individuals with incomes 200% above the poverty line receive benefits. California state and local governments spent nearly $958 billion from 1992 through 2015 on public welfare programs, including cash-assistance payments, vendor payments and “other public welfare,” according to the Census Bureau. California, with 12% of the American population, is home today to about one in three of the nation’s welfare recipients. The generous spending, then, has not only failed to decrease poverty; it actually seems to have made it worse..." Read the rest at:

Christine Anderson 2 months ago

Dear God. Every day since this baboon took office, T there are new reasons to be afraid. There is a segment of Medicaid recipients who cannot hold down a job( let alone one that would provide health insurance), and are fighting battles with Social Security to be approved for benefits. It takes about three years to get to the hearing in Topeka. In the meantime, what are so many people supposed to do? What about those who work, but do not have insurance? We're screwed, that's what. I am terrified. I'm a lung cancer survivor, as well as numerous other medical issues. I have six doctors. 18 meds. When my youngest turns 19 one year from now, bye- bye health insurance. I'm just shaking my head in disbelief at how many people have drunk the GOP kool-aid. I have some friends who think Lord Cheeto is the Second Coming, for pete's sake. Wake up, people!!!

Bob Smith 2 months ago

Stay with the name-calling. It makes you sound ever so rational. (not)

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