Washington DC — Today, the Los Angeles Times reports that the Trump administration is scrambling to overhaul Medicaid by requiring burdensome work requirements, but are failing to enforce federal rules directing states to analyze the devastating impact such requirements will have on millions of Americans who rely on this life-saving program. Brad Woodhouse, executive director of Protect Our Care, issued the following statement in response:   

“The actions by this administration are egregious, but unfortunately par for the course considering President Trump has put people in charge of Medicaid who are simply out to destroy it. Failing to enforce rules requiring states to access the impact of Medicaid work requirements shows that the Trump administration doesn’t care who their policies hurt. This is part and parcel to Trump-led Republican sabotage agenda: they oppose Medicaid expansion — which would provide health care coverage to millions more Americans, support so-call ‘block grants” — a euphemism for slashing coverage, and are pushing ‘work requirements’ – which are little more than gotcha paperwork meant to kick eligible people off the rolls. Medicaid is the nation’s largest health insurance program and is more popular today than ever before. These senseless work requirements are already jeopardizing health care for thousands of low-income families — nearly all of whom are already working — and the Trump administration is breaking every rule in the book in their rush to implement it as just another deliberate attack on American health care.”

Background:

IN STATES WHERE SIMILAR RULES HAVE TAKEN EFFECT, THOUSANDS OF PEOPLE HAVE LOST CARE

  • Results from Arkansas confirm that Medicaid work requirements are fundamentally bureaucratic hurdles, threatening access to health coverage for thousands across the state. “A review of monthly data related to the new requirements released by the Arkansas Department of Human Services shows that from September through December 2018, over 18,000 people were disenrolled for failure to comply with the new requirements for three months.” [Kaiser Family Foundation, 1/17/19]
  • This summer, a federal district court blocked Kentucky from imposing similar rules for the negative effects it would have on Kentuckians. Said the court in its ruling, “[Secretary Azar] never adequately considered whether Kentucky HEALTH would in fact help the state furnish medical assistance to its citizens, a central objective of Medicaid. This signal omission renders his determination arbitrary and capricious. The Court, consequently, will vacate the approval of Kentucky’s project and remand the matter to HHS for further review.”
  • In Indiana, 25,000 people with health insurance through Medicaid were dropped from coverage because they were unable to pay their premiums. The Washington Post reported, “About 25,000 adults were disenrolled from the program between its start in 2015 and October 2017 for failure to pay their premiums, according to state reports. Yet, state officials estimate that based on surveys of recipients, about half of those who were disenrolled found another source of coverage, most often through a job…In addition to those who were disenrolled, another 46,000 adults who signed up for Medicaid during 2016 and 2017 were not accepted because they did not pay their initial premium, the state reported.”

WORK REQUIREMENTS ADD ADMINISTRATIVE HURDLES, MAKING IT HARDER FOR PEOPLE WHO ARE ELIGIBLE FOR CARE TO GET IT

  • Requiring People On Medicaid To Prove They Are Working Adds An Administrative Burden That Is Hardest On Low-Income Americans. “[Administrative hurdles] may be especially daunting for the poor, who tend to have less stable work schedules and less access to resources that can simplify compliance: reliable transportation, a bank account, internet access.  There is also a lot of research about the Medicaid program, specifically, that shows that sign-ups fall when states make their program more complicated.” [New York Times, 1/18/18]
  • Documentation Requirements Increase The Chances That People Will Lose Care, Simply Because They Have Trouble Navigating The Process. “There is a real risk of eligible people losing coverage due to their inability to navigate these processes, miscommunication, or other breakdowns in the administrative process. People with disabilities may have challenges navigating the system to obtain an exemption for which they qualify and end up losing coverage.” [Kaiser Family Foundation, 1/16/18]

THE VAST MAJORITY OF  PEOPLE WITH MEDICAID COVERAGE WHO WHO CAN WORK ARE WORKING

  • 60 percent of nondisabled people with health coverage through Medicaid have a job and are working, including 42 percent working full-time.
  • 51 percent of working adult Medicaid enrollees have full-time jobs year-round, but their salaries are still low enough to qualify for Medicaid coverage, or have Medicaid because their employers do not offer insurance.  
  • Nearly 80 percent of nondisabled people with Medicaid coverage live in a family where at least one person is working, including 64 percent working full-time. The other adult family member may not be working because they have caregiving or other responsibilities at home.
  • A state by state breakdown can be found HERE