The guidance cites research that it says demonstrates people who work tend to have higher incomes associated with longer life spans, while those who are unemployed are more prone to depression, "poorer general health", and even death.
"It is a very major change in Medicaid that for the first time would allow people to be cut off for not meeting a work requirement, regardless of the hardship they may suffer", said Judy Solomon of the Center on Budget and Policy Priorities, which advocates for poor families.
The announcement came in a 10-page memo with detailed directions about how states can reshape the federal-state health program for low-income people.
Medicaid is the largest government health insurance program.
More than 1.2 million non-disabled working-age adults receive Medicaid in IL, and most do work. An analysis at the by Rosenbaum for the Commonwealth Fund on Thursday noted that several of the 10 states who had submitted work requirement plans projected they would reduce coverage.
In November, during remarks at a National Association of Medicaid Directors conference, Verma said the federal government was "resetting" the Medicaid partnership between the federal and state governments and said the agency would give the green light to "community engagement" proposals.
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These individuals still struggle to work due to their health issues, but many will not be allowed an exemption under the new Medicaid requirements. The work requirements will likely be challenged in court. Numerous specialists expect Kentucky will be the primary state endorsed.
This will be the first work requirement in Medicaid's 52-year history.
"This policy move does not include a single penny to job training, does not add a penny to job placement, does not add a penny to job creation", Berg remarked.
"Health care is a right that shouldn't be contingent on the ideological agendas of politicians", said Sen. Ron Wyden of Oregon. Almost 8 in 10 are part of families where at least one person works, and 60 percent are working themselves. 36% said they were ill or disabled, 9% said they were retired, and 30% said they were taking care of family or their home. Other requested changes include requiring Medicaid recipients to undergo drug screening and seek treatment if they test positive. The guidance gives states some flexibility in determining what types of activities should be counted toward work requirements and grants exemptions for certain groups, such as pregnant women. States should ensure that career planning, job training, referral, and volunteering opportunities considered to meet the community engagement requirement, and job support services offered in connection with the requirement, take into account people's employability and potential contributions to the labor market.
"It's basically creating layers of government, confusion, bureaucracy that doesn't need to be there for people who are probably working anyway", she said.
Ten states, including Arizona, Arkansas, Indiana, Kansas, Kentucky, Maine, New Hampshire, North Carolina, Utah and Wisconsin, have already filed applications with CMS to add work requirements to their Medicaid programs.
Now that the work requirement has been approved, Miller said he expects "quick approval" of the state's proposal he said will help "Medicaid beneficiaries improve their social, educational, and health outcomes". The administration says the impact will be closely evaluated. Many governors, including Republican ones, have defended the Medicaid program as being critical to addressing the substance abuse crisis. "It will be interesting to see how states are going to make this work for people".