New Requirement Could Push 95K Off Medicaid in Kentucky

Illustration created using Getty Images

Illustration created using Getty Images

Kentucky Governor Matt Bevin (R) explained his support for the state's new Medicaid policy during a phone interview with Fox News on Friday. Instead, how much more costly will Medicaid be if counselors or social workers or whoever is hired to track down the work status - or the alternative community service status or enrollment in school or job training - of the millions of adults who are eligible for the program? Just a day later, Kentucky took them up on that offer. While Carolina Cares is awaiting legislative action from the General Assembly, it should be noted that Carolina Cares has language to impose work requirements if it should be enacted. Long-term welfare tends to trap people in poverty, and policies like work requirements free welfare recipients from the trap. The requirement doesn't apply to those with disabilities, the pregnant, or the elderly.

Bevin, a fierce opponent of ObamaCare, was elected in 2016 partly on a promise to change the state's expansion of Medicaid that came as part of the law. Under state work requirements, people have to verify their work status or their qualification for an exemption, according to, associate director of Kaiser Family Foundation's Program on Medicaid & the Uninsured.

The bottom line: Though they may make for good political headlines, Medicaid work requirements are wasteful and ineffective.

According to his own administration, the work requirements will result in 95,000 fewer people on Kentucky's Medicaid rolls.

"I am pleased to see that the Trump administration has recognized the value of the Kentucky HEALTH proposal and has approved Kentucky's Medicaid waiver application", said Guthrie.

In Kentucky, which expanded Medicaid, Republican state Sen. They also hearken back to the program's original intent, he added, "as temporary assistance to try to help people get back on their feet, not a permanent subsidy for someone's lifestyle, if they're capable of working".

The waiver's prospects didn't look promising under the Democratic administration of Barack Obama but was viewed here as an nearly certainty once Republican Donald Trump was elected president.

That money pays for salaries of doctors, nurses, home health aides, who spend the money in Kentucky communities on homes, cars and groceries, he said. And Virginia House and Senate Democrats announced Thursday that Medicaid expansion is their top goal for this legislative session.

The debate about work requirements doesn't break neatly along liberal-conservative lines.

Kentucky has become the first state in the nation to receive federal approval to impose work requirements as a condition of Medicaid coverage. Research shows that 80 percent of Medicaid enrollees already belong to working households and that 60 percent are working themselves. Almost 60 percent work either full time or part time, mainly for employers that don't offer health insurance. Or they're caring for a child or family member, or they're sick or disabled.

For instance, the guidance notes that some Medicaid recipients may have trouble meeting these requirements because of poor health, substance abuse or high unemployment in their areas.

The agency specifically calls out the opioid epidemic, saying that time spent in treatment can count towards the mandate and those in intensive recovery programs can be excused. The is the first of what are expected to be similar approvals for nine other states and a likely first step in pushing Medicaid policy into the courts. The Trump administration, to its credit, seems to understand this. Although waivers can have lasting impact they don't amount to a permanent change in the program. But many of those would drop out not because of finding work but because they can't overcome the new bureaucratic hurdles, say advocates for the poor.

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