The Trump administration has signaled to states that it is open to a wide range of ideas that will have a direct impact on Medicaid beneficiaries. Recently, the Centers for Medicare and Medicaid Services (CMS) approved a “first-of-its-kind” waiver that allows for work requirements, veiled as “community engagement,” to be established in Kentucky. Referred to as KY HEALTH (Helping to Engage and Achieve Long-Term Health), the waiver not only puts work requirements in place but also makes other changes to the program’s structure that consumer health advocates have fought against for years including requiring monthly premiums and locking people out of coverage if premiums have not been paid or work requirements have not been met.
Kaiser Family Foundation (KFF) offers an overview of Kentucky’s Section 1115 waiver as well as the lawsuit filed challenging the authority of CMS to approve work requirement policy.
The Indiana Section 1115 waiver changes the state’s Health Indiana Program (HIP) by adding work requirements as a condition of eligibility in 2019, charging monthly premiums, putting in place coverage lock-out periods for those who fail to pay their premiums or meet the work requirements, and putting in place a premium surcharge for those who use tobacco (another “first-of-its-kind”). Additional details can be found in the KFF overview.
If you are interested in learning if your state has a pending Medicaid waiver, KFF has developed a table that is tracking Medicaid waivers. According to the resource, seven states (Arizona, Kansas, Maine, Mississippi, New Hampshire, Utah, and Wisconsin have pending waivers with work requirements.
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