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Seema Verma was nominated to be the administrator for the Centers for Medicare and Medicaid Services (CMS) on November 29, 2016 by President Trump, and her nomination was confirmed shortly after in March.
It didn’t take long for Verma to make headlines with her first course of action, a letter sent to the states in regards to Medicaid. The letter promoted changes to Medicaid laws that included new premiums for Medicaid recipients, payment for emergency room visits, and pushing for Medicaid eligible individuals to get jobs in order to qualify the federal healthcare program.
The new Medicaid policies encouraged by the CMS are known as Medicaid work requirements. Medicaid work requirements have been met with backlash and applause, and multiple “Red" states have already submitted their waiver requests to implement the policies. Kentucky was the first state to be approved by the Trump administration that would require Medicaid recipients to work, or participate in work related activities.
Medicaid Work Requirements - An Act Of “True Compassion"
The Trump administration claimed to have proposed these new Medicaid requirements as an act of “True Compassion." The goal is not just to provide healthcare services to people who need it the most, but to help Medicaid beneficiaries pull themselves out of poverty. Seema Verma built upon this point when she stated:
"True compassion is lifting Americans most in need out of difficult circumstances… The Administration stands for a policy that makes Medicaid a path out of poverty by empowering states to tailor programs that meet the unique needs of their citizens."`
While the move may appear to be a way to reduce overall spending, and in turn reduce the federal deficit, there is some merit to their move. Studies have found links and correlation between income level, employment, and an individual’s overall health. However, the Medicaid work requirements may have an adverse effect, as it will reduce the amount of Americans eligible for state sponsored healthcare.
The Democratic Opposition
Trump’s healthcare bills have been heavily scrutinized, and received huge amounts of backlash from the Democratic party, and this is no exception. In a press release, House Democrats claimed the move is unlawful, and furthermore, immoral.
"Actions to tie health coverage to work are motivated purely on the basis of ideology and mistaken assumptions about what Medicaid is and who it covers"
According to the Democratic stance, “most of those who can work, are working." The concern surrounds those who work, but still don’t make enough money, or meet the new Medicaid requirements that afford access to healthcare.
Current Medicaid Demographics
2017 numbers showed that nearly 75 million Americans were enrolled in the government healthcare programs Medicaid and CHIP. It’s estimated that just over 50% of those beneficiaries were children. The Kaiser Family Foundation took it a step further, and broke down Medicaid recipients into the following categories:
- Working Medicaid Recipients: 60%
- Non-Working Medicaid Recipients: 40%
- 36% ill or disabled
- 30% taking care of family or home
- 15% in school
- 9% retired
- 6% unable to find work
- 3% other
Work Related Activities And Exemptions
The term Medicaid work requirement does sound a little misleading, although the premise is spot on. There will be exceptions to the rule, and “work" may have a looser definition than originally thought, as some work related activities will meet the work requirement. Examples include:
- Searching for work
- Job training
- Illness or disability
- Opioid or addiction rehabilitation
States who obtain waivers for Medicaid work requirements would also be encourage to create programs that would help residents on Medicaid obtain work. However, it’s important to note that those programs would not come from Medicaid funding, states would have to pull resources from elsewhere.
Under the new Medicaid policies, there will be individuals who lose access to healthcare from failing to meet state requirements. The ultimate goal though is to help more Americans find employment, and use their finances to purchase private health insurance.