Saturday, 20 January, 2018

Bevin touts 'transformational' Medicaid overhaul as critics fear sicker Kentuckians

US moves to limit Medicare the publicly funded health insurance program for the poor and disabled have been the subject of protests like this one in July,2017 in New York City Illinois Reviewing Medicaid Work Rule
Sammy Stanley | 13 January, 2018, 05:26

Liberal-leaning groups had already hinted at challenging Medicaid work requirements in court before the Kentucky waiver was approved, and some of those same groups harshly criticized at the policies in the state's demonstration project.

Bevin, who ran for governor in 2015 on a promise to repeal Kentucky's wildly successful Medicaid expansion, said Friday that the changes "will be transformational".

Bevin said that requiring able-bodied recipients to work, to give something in return for the insurance they're receiving, gives them dignity, respect and an opportunity to escape from a "dead-end entitlement trap".

"We owe beneficiaries more than a #Medicaid card", tweeted CMS Administrator Seema Verma Thursday.

Enrollees who will be exempt from this include full-time students, former foster care youth, pregnant women, people with an acute medical condition and primary caregivers.

Kaiser Health News (KHN) is a national health policy news service. For example, the federal law only authorizes the secretary to allow states to ignore Medicaid's consumer protections when a state is implementing an experimental project created to promote the objectives of the Medicaid Act.

The federal Centers for Medicare and Medicaid Services informed Bevin's administration Friday of the approval on an 1115 waiver to tailor the federal program which provides health coverage for the poor, disabled and elderly to match Kentucky's population and circumstances.

"Everybody wants to increase employment, that's a great goal, but this is not the right way to go about that", said Alker.

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Critics say the work requirement proposal - which was repeatedly rejected by the Obama administration on the argument it would interfere with providing health coverage - is a more subtle way to reduce the number of non-disabled adults added to Medicaid under the Affordable Care Act. Those generally include requirements for recipients to be working, be looking for work, volunteering or in school.

Why can't the USA provide both a cost-effective safety net for health care and opportunities for people to find meaningful work?

Work requirements could have the biggest impact in states that did not expand Medicaid under the ACA.

Many people insured through Medicaid are working low-income jobs with unpredictable and irregular hours.

New Hampshire Senate Majority Leader Jeb Bradley welcomes the opening for work requirements for able-bodied, childless adults, and said it will be incorporated into the reform process. After that, their benefits will cease until they prove they have begun following the rules. We know from experience with other benefit programs that eligible people already working or deemed exempt from working are likely to lose coverage simply because of added paperwork and enrollment hurdles - not because they are ineligible. Bevin said he expects the program to be fully implemented at the beginning of next year. He estimates as many as 100,000 Medicaid enrollees will lose coverage as a result of the waiver.

States will be required to describe strategies to assist recipients in meeting the requirements and to link them to job training and support resources, including child care and transportation. If state officials think that's going to help move people out of poverty, they don't need Washington telling them otherwise.

"When many doctors refuse to accept Medicaid patients or place restrictions on patient access to care, it becomes harder for parents to find quality physicians for their children within a reasonable geographic area", said senior study author Dr. Andrew Racine, a researcher at Albert Einstein College of Medicine and Montefiore Health System in Bronx, New York.

Although the first waiver has been approved, the road to work requirements could be longer than their supporters hope: Health policy experts anticipate that lawsuits will be filed quickly.

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