Trump Gets Tough on Medicaid: If You’re ‘Able-Bodied’ Adult, You Might Actually Have to Work for It


The Trump administration announced Thursday it is offering a path for states that want to seek work requirements for Medicaid, according to CNBC.

“The administration’s latest action spells out safeguards that states should consider to obtain federal approval for waivers imposing work requirements on ‘able-bodied’ adults,” CNBC reports.

“Technically, those waivers would be ‘demonstration projects.’ In practical terms, they would represent new requirements for beneficiaries in those states.”

In other words, states can experiment with different initiatives to see what creates a better environment to encourage more able-bodied Americans to work in order to “earn” the benefit.

Ten states have applied for waivers that involve community involvement. Most of them are under conservative leadership.

But Thursday’s announcement comes with caveats, ensuring these stipulations are only applied to “able-bodied” people. Among them are:

  • Exempting pregnant women, disabled people, and the elderly.
  • Taking into account hardships for people in areas with high employment, or for people caring for children or elderly relatives.
  • Allowing people under treatment for substance abuse problems to have their care counted as “community engagement” for purposes of meeting a requirement.

Both the federal government and the states share the financial burden of Medicaid services that covers 70 million people, or 1 in 5 Americans. White House officials have said the cost of Medicaid spending is growing at an unsustainable rate.

Medicaid already accounts for over 25 percent of a growing share of total state spending, according to the Urban Institute.

Obamacare’s Medicaid expansion added 11.5 million adults to the program, largely funded at first by the federal government. But starting last January, states had to begin paying 5 percent of the cost of all those newly eligible to receive Medicaid, according to Investor’s Business Daily.

Some states had already begun adding taxes and fees on providers to cover costs; other states shifted the costs to “general funds.”

States’ only options were to boost health care costs, raise taxes, or cut spending to cover Obamacare’s Medicaid expansion.

The Trump administration’s announcement could give states another way to reduce costs, providing for some flexibility.

“The Trump administration said that states imposing work requirements must have plans to help people meet those requirements and must connect them with job training,” according to The New York Times.

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