Mike Pence's home state can now require Medicaid recipients to work

Vice President Mike Pence and Seema Verma revolutionized Medicaid in Indiana a few years ago.Now, the Trump ad...

Posted: Feb 3, 2018 1:58 PM
Updated: Feb 3, 2018 1:58 PM

Vice President Mike Pence and Seema Verma revolutionized Medicaid in Indiana a few years ago.

Now, the Trump administration, in which they both serve, has allowed the state to implement even more changes in the safety net program -- most notably by requiring some Medicaid recipients to work.

The state, which has served as a Medicaid expansion model for Republicans, announced Friday that it will require certain Medicaid recipients to get jobs or participate in other community activities starting in 2019. The mandate applies to up to 130,000 working age Hoosiers who are not disabled, medically frail, pregnant or parents of young children. Those who fail to comply could be locked out for three months.

Indiana becomes the second state to be granted permission to impose work requirements, which Verma championed first as a consultant for states looking to overhaul their programs and now as administrator of the Centers for Medicare & Medicaid Services, which rules on such requests. Kentucky's waiver got the nod last month.

The approvals mark the first time ever that states have been allowed to mandate recipients to work in exchange for benefits. At least 11 other states have filed similar requests or are looking to do so.

Related: Kentucky is first state ever to require Medicaid recipients to work

State waiver requests must promote Medicaid's mission, which is to provide the poor with access to medical care. The Trump administration and Republican officials are positioning work requirements as an opportunity to improve Medicaid recipients' health.

"Medicaid can become a pathway out of poverty," said newly confirmed Health Secretary Alex Azar, a former executive for Indiana-based Eli Lilly. Having a sense of purpose, often obtained through work, helps bolsters one's health and life, he added.

Consumer advocates, however, say such measures will leave many more Americans uninsured. Already, three groups are suing the administration seeking to stop the approvals.

Related: Lawsuit seeks to stop Medicaid work requirements

Indiana's newly approved waiver builds upon a dramatic overhaul of its Medicaid program under then-Governor Pence in 2015, which brought more than 400,000 people into the system.

Pence, who is now vice president, agreed to expand Medicaid and even offer participants the option of limited dental and vision benefits. But, in return, the Obama administration granted the state the first-ever approvals to charge premiums to newly eligible adults with incomes as low as $0, impose a six-month lockout period for those with incomes above the poverty line who miss two months of premiums and require co-pays of up to $25 for repeated non-emergency use of the emergency department.

Currently, enrollees in Healthy Indiana 2.0, as the expansion program is known, must pay monthly premiums of 2% of household income as a contribution to an account similar to a health savings account.

Under the newly granted waiver, smokers who don't participate in tobacco cessation activities will face premium surcharges as an incentive to engage in healthy behaviors. Also, the state will start assessing premiums based on income, though it notes that most beneficiaries will pay no more than 2% of their household income.

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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