“The Trump administration said [on Friday, September 21, 2018] it will review Alabama’s request to impose work requirements on its Medicaid population.
While the administration has made work rules a hallmark of its Medicaid policy, CMS so far has approved them only for programs that were expanded under the Affordable Care Act. Alabama has not expanded Medicaid and its program already has some of the strictest eligibility requirements in the nation — a four-person household with income of $5,000 a year would make too much to qualify.
Alabama, whose waiver request responded to issues raised by the Trump administration over the summer, is asking that its Medicaid work rules largely mirror those already in place for its TANF program — meaning that they would be more stringent than requests that have already been approved for other states. Kentucky and Arkansas, for example, require recipients to document 80 hours a month of work or community engagement.
Alabama is proposing that able-bodied adults report 35 hours of work per week in order to maintain coverage. Parents of children under six would only have to report 20 hours per week. Recipients would have 90 days to comply with the requirements before being disenrolled from Medicaid.
So far, only Arkansas has implemented work requirements, and last week disenrolled more than 4,300 recipients. Kentucky’s program was halted by a federal judge. The Trump administration responded by re-opening the comment period in hopes of showing the judge that it had considered the negative consequences.
But an analysis of more than 9,000 new comments by three Kentucky-based organizations found them opposed by more than 20 to 1.”
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