Medicaid work rules in Arizona, Indiana discarded by CMS

The Centers for Medicare & Medicaid Services pulled plugins on Arizona and Indiana plans to require some Medicaid beneficiaries to work, attend job training or participate in other activities to maintain their coverage. according to letters the federal agency sent to the two states on Friday.

President Donald Trump’s approved resignation administration was unlikely to further the Medicaid goals, which federal courts have decided to provide health insurance, CMS administrator Chiquita Brooks-LaSure wrote in the letters. The pandemic also presents challenges to the Medicaid population which makes work requirements particularly heavy, he wrote. At this time, beneficiaries may lack access to affordable economic opportunities, transportation, and child care when the public health emergency is gradually reduced. The imposition of a work requirement in these circumstances could lead to unfair losses of benefits, he wrote.

“Losing health coverage will no doubt have negative consequences for affected beneficiaries down the road,” Brooks-LaSure wrote.

The waivers had not taken effect in both states, since both had accepted a temporary 6.2% increase in federal funding for their Medicaid programs during the public health emergency. This prevented them from removing people from the program.

CMS reversal of these work requirements is part of it the Biden administration’s commitment to expanding health coverage. No state currently has an active work requirement, in part due to disputes and partly because they delayed implementation during the pandemic.

Democrats, consumer advocates and many health experts oppose the work requirements for Medicaid coverage, arguing that they lead to considerable coverage losses and do not increase employment. Research supports this dispute. When Arkansas enacted work requirements in 2018, more than 18,000 people, nearly a quarter of Medicaid entrants subject to the rule, lost coverage, according to a study published in the journal Health Affairs. In addition, these individuals have suffered significant financial and health consequences – and political ones it did not lead to job gains, the study found. More than 6 in 10 adult Medicaid beneficiaries of working age without disabilities are already employed, according to survey data compiled by the Kaiser Family Foundation in 2019.

Conservative decision makers always insist that they require people to work to receive them Medicaid coverage encourages them more to look for employment. That will improve their long-term well-being and ensure that people do not receive benefits to which they are not entitled, supporters such as former CMS administrator Seema Verma have argued.

However, most analysts believe that having health coverage makes work easier by keeping people healthy, not that the loss of benefits favors work. They also believe there are better ways to encourage Medicaid-eligible people to get paid or higher-paying jobs.

CMS notified it said in February that it would review the previously approved work requirements. That followed a January executive order by President Joe Biden that ordered federal agencies to review policies that make it more difficult for people to access or pay for coverage. The agency has yet to decide the fate of the job-requiring policies in Georgia, Ohio, South Carolina and Utah, but it’s only a matter of time before CMS abandons its waivers.

The Supreme Court dismissed the oral arguments in March in a case challenging the legality of Medicaid work requirements in Arkansas and New Hampshire after the Biden administration withdrew its support for the lawsuit, which the previous administration argued.