Posted by 12 February 2021
Under the Trump Administration, states began to require some Medicaid recipients to seek work. This week, the Biden Administration is planning to revoke federal permission for states to do this.
These work requirements differed across the states, but they generally mandated that individuals eligible for Medicaid under the Affordable Care Act, or Obamacare, must meet certain work requirements or undertake work-related activity. These requirements applied only to those recipients in the Medicaid expansion population – able-bodied adults without children who are between 18 and 62. There are also exceptions for people who are unable to work.
States had asked the Obama Administration for permission to enact Medicaid work requirements, but the Department of Health and Human Services at the time did not approve them. The Trump Administration did. However, federal judges have blocked many of these requirements from going into effect. This spawned court battles, with lower courts ruling against the Trump Administration.
The legal issues center on whether federal law permits states to add a work requirement to Medicaid recipients. Medicaid is funded in part by the federal government, but states opt into it and have some leeway to design their programs. The Trump Administration supported states that said they have the authority to require work for some able-bodied recipients. Federal courts have ruled that Congress must amend the program to allow this. The Supreme Court is scheduled to take up this argument in March.
While no states have Medicaid work requirements that have gone into effect because of these legal battles, they are still approved by the federal government. The Biden Administration is set to revoke these approvals, which may make the Supreme Court case moot.
Supporters of work requirements argue that they are helping Medicaid recipients by giving them an incentive to go to work, where they may be able to obtain private health insurance eventually. They also argue that childless, able-bodied adults -- the group covered by the work requirement -- should be working. Opponents, however, see these requirements as a way to limit participating in Medicaid, noting that 18,000 people lost eligibility once Arkansas put its requirement in place. They also contend that the work verification rules are too difficult for many to comply with.
Do you support requiring able-bodied Medicaid recipients to work or seek work?