"We expect that fewer people will be able to stay enrolled in coverage due to all of the red tape and penalties they'll encounter", said Emily Beauregard, executive director for Kentucky Voices for Health, an advocacy group.
Bevin noted in a news conference Friday that Kentucky's is the first waiver with a community engagement requirement approved. Prior to Medicaid expansion, many of these workers simply went uninsured, and too often missed out on needed care - and they still do in states that haven't expanded the program.
The Trump administration early Thursday initiated a pivotal change in the Medicaid program, announcing that for the first time the federal government will allow states to test work requirements as a condition for coverage.
Kentucky also anticipates the most drastic drop in Medicaid enrollment out of the 10 states with pending work requirement waivers, according to by the Commonwealth Fund.
"They are illegal and not permissible under law", said Leonardo Cuello, a lawyer with the Washington-based National Health Law Program, which anticipates filing a lawsuit challenging Kentucky's plan. They could also take a financial or health literacy course.
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"It's conceivable", he said. The state predicts that a full 15 percent of its Medicaid beneficiaries will lose their coverage within five years of the waiver's implementation.
The Bevin administration says it will reach out to enrollees starting Friday, and the program will kick off in July.
Those who don't comply would be suspended from receiving health care benefits until they meet their required hours for a month. "While we are still reviewing the details of this approval, we have yet to identify such an experiment, and the action appears created to achieve significant cuts in Medicaid enrollment rather than Medicaid's stated goal of furnishing medical assistance to low-income people", Perkins said. If an individual already satisfies a work requirement in Supplemental Nutrition Assistance Programs (SNAP or "food stamps") or Temporary Assistance for Needy Families (TANF), then they will automatically satisfy the Medicaid requirement. "It's not about employment encouragement".
Ultimately, the most obvious effect from imposing work requirements in Medicaid will be to deprive more people of the health coverage they need to live healthy, productive lives.
Medicaid is already expected to be a hot topic at the Statehouse this year, as the New Hampshire Health Protection Program, or Medicaid expansion, is set to be renewed. The requirement would not apply to some participants, including pregnant women, those being treated for substance abuse, "the medically frail" and those older than 60. Whether called "work requirements" or "community engagement", these bureaucratic provisions will be costly and time-consuming.
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The Obama administration turned down several state requests to add a work requirement. That's if they receive notification or understand new rules of the program, he said.
"Medicaid needs to be more flexible so that states can best address the needs of this population", Seema Verma, administrator of the Centers for Medicare & Medicaid Services (CMS), said in a press release.
"There is a real risk of eligible people losing coverage due to their inability to navigate this process or miscommunication or other breakdown in the administrative process", she said in an email to HuffPost. It is also contrary to HHS's claim that "work requirements" promote work. The difference this time around is that the federal government will recognize it.
The Maine Department of Health and Human Services a year ago sought federal Medicaid officials' permission to require non-disabled, low-income adults enrolled in Medicaid to work as a condition of receiving coverage.
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