In a major departure from more than 50 years of U.S. health care policy, the Trump administration will let states move toward imposing work requirements on people as a condition for obtaining health insurance under the Medicaid government program for the poor, The Independent reported. The proposed change will allow states to deny access to Medicaid to certain low-income adults, as part of a sweeping welfare reform that many Republicans have demanded for years. A letter from Centers for Medicare and Medicaid Services (CMS) Deputy Administrator Brian Neale declared that the Trump administration was “incentivizing work and community engagement” by allowing states to exempt certain adults from the program if they were not working or participating in “community engagement.” More than 70 million Americans depend on Medicaid for health insurance. While other social safety nets — such as welfare and food stamp programs — have been reformed over the years to include work requirements, health care access has been viewed by most policy experts as a right. Under the new rules, however, states can apply for a waiver to impose work requirements on Medicaid beneficiaries. Ten states have already applied for a waiver and three more are considering doing so. The Trump administration could approve the first waiver as early as Friday. When applying for a waiver, states must justify how the work requirement would “further the objectives” of Medicaid. They must also allow elderly people, pregnant women, people with disabilities and those “determined by the state to be medically frail” to be exempted from the requirement.
