Kentucky is first state ever to require Medicaid recipients to work

Kentucky will now require many of its Medicaid recipients to work for their benefits, the first time ever a state has...

Posted: Jan 13, 2018 3:07 PM
Updated: Jan 13, 2018 3:07 PM

Kentucky will now require many of its Medicaid recipients to work for their benefits, the first time ever a state has been permitted to impose such a requirement.

The state announced Friday that it received federal approval to mandate certain Medicaid enrollees to hold jobs or participate in other employment activities for 80 hours a month. The decision came a day after the Centers for Medicare & Medicaid Services unveiled guidelines for states to file for work requirement waivers.

Also, Kentucky can start charging its Medicaid enrollees monthly premiums ranging from $1 to $15, depending on income, and suspend some of those who fall behind in payments. The state will also provide recipients with a high-deductible health savings account, which it will fund, and offer incentives to purchase additional benefits, such as dental and vision coverage.

The work requirement, which will take effect in July, will apply to all able-bodied, working-age adults who are not pregnant, medically frail, full-time students or primary caregivers of dependents. About 350,000 Kentucky residents will be subject to this mandate, but about half of them have jobs or are in other activities that would satisfy the requirement.

In addition to working, recipients can meet the requirement by volunteering, participating in job training or job searching and taking classes.

Allowing states to impose work requirements is a historic shift in the 53-year-old federal health insurance program for the poor, but not an unexpected one.

Related: Trump administration allows states to make Medicaid recipients work

Republicans have long wanted to add work requirements to the Medicaid program, which covers nearly 75 million low-income children, adults, elderly and disabled Americans. The broadening of Medicaid to low-income adults under Obamacare -- roughly 11 million have gained coverage under the health reform law's Medicaid expansion provision -- further spurred GOP efforts.

However, the Obama administration did not approve any state waivers that would impose work mandates, saying it was not in keeping with the program's mission to provide access to medical services. Consumer advocates and health policy experts fear that such a requirement could prove a big hurdle for many recipients, leaving them without the care they need.

Related: In a small Kentucky coal town, joblessness leads to a health crisis

The Trump administration swiftly signaled that it held a different view. Seema Verma, the CMS administrator, sent a letter to governors hours after after she was confirmed in March urging them to apply for such waivers.

Kentucky's Medicaid overhaul is expected to be challenged swiftly in court. Consumer advocates say work requirements are contrary to Medicaid's mission to provide access to health care. They are concerned that low-income adults will lose access to the program because they are too sick to work, even though they are not classified as disabled, or because they get tripped up by the documentation requirements.

Kentucky officials project that between 90,000 and 95,000 fewer people will be in the state Medicaid program at the end of the five-year waiver period.

Indiana Coronavirus Cases

Data is updated nightly.

Cases: 1084488

Reported Deaths: 17386
CountyCasesDeaths
Marion1425562217
Lake705171220
Allen64347862
Hamilton49481481
St. Joseph48135639
Elkhart39011536
Vanderburgh33874494
Tippecanoe29863271
Johnson26876463
Hendricks25548379
Porter24683380
Madison20440444
Clark19785275
Vigo18609308
LaPorte16638260
Monroe16237217
Delaware16230286
Howard16181310
Kosciusko13763162
Hancock12644184
Bartholomew12544188
Warrick11889189
Wayne11794264
Floyd11792225
Grant11484233
Morgan10134188
Boone9576120
Noble8921121
Henry8917163
Marshall8792146
Dearborn875798
Dubois8673138
Shelby7958127
Cass7907126
Lawrence7861182
DeKalb7416106
Jackson738093
Huntington7280107
Gibson6922118
Montgomery6830122
Harrison680696
Knox6779113
Steuben641185
Miami6384106
Whitley631160
Putnam626582
Clinton614176
Wabash5958108
Jasper591991
Jefferson5617102
Ripley540892
Adams527881
Daviess4964116
Scott475978
Wells462998
White459967
Greene458399
Clay452162
Decatur4491109
Jennings434666
Fayette429094
LaGrange413890
Posey398344
Washington380654
Randolph3770107
Fountain364962
Spencer353446
Fulton352270
Starke343672
Sullivan342454
Owen341676
Orange320270
Jay315450
Rush293332
Carroll287037
Franklin283544
Perry281453
Vermillion277557
Parke244930
Tipton244664
Pike241744
Blackford213944
Pulaski203158
Newton176552
Brown169850
Crawford167129
Benton160517
Martin149219
Switzerland143712
Warren131416
Union115416
Ohio90513
Unassigned0581

Ohio Coronavirus Cases

Data is updated nightly.

Cases: 1673496

Reported Deaths: 26483
CountyCasesDeaths
Franklin1757641826
Cuyahoga1629012636
Hamilton1118741528
Montgomery791421387
Summit697231199
Lucas615331017
Butler55597803
Stark521611170
Lorain40661639
Warren35239412
Mahoning34821769
Lake31171493
Clermont30541362
Delaware26553182
Trumbull26366611
Licking26095335
Medina25072351
Fairfield24063287
Greene23957369
Clark21542387
Portage20538280
Richland20465336
Wood19524246
Allen18427320
Miami16950348
Columbiana16385331
Muskingum16346206
Wayne15351304
Tuscarawas14018357
Marion12978194
Erie12350198
Ashtabula12171225
Scioto12166182
Pickaway12009151
Ross11417223
Hancock11151173
Geauga10572174
Lawrence10433171
Belmont10200231
Huron9545155
Jefferson9425225
Union933375
Sandusky8981166
Seneca8639156
Knox8591169
Washington8578156
Athens825096
Darke8215179
Ashland7777147
Auglaize7695115
Shelby7302132
Defiance7174114
Brown7015115
Crawford7010150
Fulton6953111
Logan6818108
Mercer679397
Guernsey677983
Highland6591117
Madison639289
Clinton6361106
Williams623498
Preble6153139
Putnam6054120
Jackson569496
Champaign564786
Perry557179
Coshocton5525103
Ottawa549599
Morrow504464
Fayette481270
Hardin475399
Gallia460278
Pike457876
Van Wert451591
Adams4495109
Henry422776
Hocking398093
Holmes3917137
Wyandot366673
Carroll348978
Paulding317449
Meigs300957
Monroe230860
Noble216147
Morgan208938
Harrison204052
Vinton182037
Unassigned05
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