Washington DC – Today CMS approved Wisconsin’s plan to dramatically restrict Medicaid enrollment by taking coverage away from people who do not meet new burdensome work requirements or who cannot afford to pay new burdensome premiums. In response to the announcement, Brad Woodhouse, executive director of Protect Our Care, issued the following statement:

“Let’s be clear: At a time when Scott Walker is in the political fight of his career — promising over and over again that he’ll protect people with pre-existing conditions — here he is teaming up with Donald Trump to rip health care away from the families who need it the most. Wisconsinites, the vast majority of whom want to ensure people with pre-existing conditions get the coverage they need, must judge Scott Walker by what he does, not what he says. Because despite all his recent talk about protecting people, all he really does is use his power as Governor to put barriers between the hardworking people in his state and the care and coverage they need.”

BACKGROUND

MEDICAID IS A LIFELINE FOR…

…CHILDREN & FAMILIES

…PEOPLE WITH DISABILITIES

  • Nearly 8.7 million adults enrolled in Medicaid have a disability. Of this group, only 43 percent qualify for social security income.

…SENIORS

  • More than 6.9 million American seniors have Medicaid coverage. 6,920,200 seniors, age 65 and older, are enrolled in Medicaid.
  • Medicaid funds 53 percent of long-term care nationwide. As seniors age, long-term care services become more and more vital, serving half of seniors over age 75 and three in four seniors over age 85.
  • Medicaid covers 6 in 10 nursing home residents. The average annual cost of nursing home care is $82,000 — nearly three times most seniors’ annual income.

…PEOPLE SUFFERING FROM OPIOID USE DISORDER

  • In 2014, Medicaid paid for 25 percent of all addiction treatment nationwide.

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

  • Early results in Arkansas confirm that Medicaid work requirements are fundamentally bureaucratic hurdles, threatening access to health coverage for thousands across the state. “The early results suggest that the incentives may not work the way officials had hoped. Arkansas officials, trying to minimize coverage losses, effectively exempted two-thirds of the eligible people from having to report work hours. Of the remaining third — about 20,000 people — 16,000 didn’t report qualifying activities to the state. Only 1,200 people, about 2 percent of those eligible for the requirement, told the state they had done enough of the required activities in August, according to state figures.” [New York Times, 9/24/18]
  • 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.”

TAKING AWAY SOMEONE’S HEALTH CARE DOES NOT HELP THEM TO WORK

  • Evidence suggests that such work requirements hurt, rather than help enrollees’ ability to find work. A study of Michigan’s Medicaid “illustrates the functional barriers to work that Medicaid beneficiaries face, and many of them result from physical and mental health challenges. This suggests to us that taking away their health coverage means that they are less likely to find work – not more so…a stable source of health coverage such as Medicaid is likely to assist people with their chronic mental and physical health conditions so that they are better able to seek employment.” In both Ohio and Michigan, having access to health care made it easier for the unemployed to find work: “majorities said that gaining health coverage has helped them look for work or remain employed. Losing coverage — and, with it, access to mental health treatment, medication to manage chronic conditions, or other important care — could have the perverse result of impeding future employment.

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