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States Given Go-Ahead to Require Medicaid Recipients to Work

Some low-income adults may have to get a job to keep health coverage

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Ten states have already applied to take advantage of the policy change and institute work requirements.
Hoxton/Tom Merton/Getty Images

Federal officials gave states the green light Thursday to impose work requirements on Medicaid recipients as a condition of their receiving benefits. 

In a letter to state Medicaid directors, the Centers for Medicare and Medicaid Services (CMS) spelled out what states need to do to apply for permission for this first-ever work requirement in the 52-year history of Medicaid, the federal-state health program for the poor and disabled.

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Under the new policy, states could ask adults who are able to work to get a job, go to school, get job training or volunteer in the community. The letter noted that the elderly, disabled, pregnant women and children would be exempt.

CMS said working and getting involved in community activities may improve the health of Medicaid recipients. It also pointed to the work requirements already in place in welfare programs and in the Supplemental Nutrition Assistance Program (SNAP), known as the food stamp program.

Opponents say the Medicaid statute would need to be changed for a work requirement to be legal. “The Trump administration is on wobbly legal ground in trying to limit Medicaid enrollment by imposing onerous work requirements,” Jane Perkins, legal director of the National Health Law Program, said in a statement Thursday. 

Ten states have already applied to take advantage of this policy change and institute work requirements: Arizona, Arkansas, Indiana, Kansas, Kentucky, Maine, New Hampshire, North Carolina, Utah and Wisconsin.

About 70 million Americans are enrolled in Medicaid. According to the nonpartisan Kaiser Family Foundation, about 60 percent of nondisabled adults under 65 who are on Medicaid are already working.

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