On January 11, 2018, the Centers for Medicare and Medicaid (CMS) administrator, Seema Verma, issued guidance to state Medicaid directors authorizing Section 1115 waivers to place work requirements on individuals receiving Medicaid coverage. A work requirement would require individuals on Medicaid to verify and participate in activities such as employment, job search, or job training programs, for a certain number of hours per week to recieve health care. Exempted populations include people with certain disabilities, the elderly, students, and caregivers, however there is little information about how exemptions would be obtained. Kentucky was the first state to receive approval for a work requirement waiver (however it was later blocked by the court).
The Epilepsy Foundation believes that everyone, including Medicaid enrollees, should have access to quality and affordable health coverage. Work requirements impose administrative and financial barriers that jeopardize patients' access to comprehensive and affordable care. Individuals would need to report the number of hours worked or whether they meet a certain exemption. Failing to to navigate the administrative requirements could have serious - potentially life-threatening - consequences for people with serious or chronic diseases. Individuals are at risk of being locked out of their health care coverage for several months.
Medicaid work requirement proposals have been rejected in the past on the basis that they would make it more difficult for people to access health coverage. Significant barriers include administrative challenges in verifying participation and lack of criteria for rights of people with disabilities who are unable to work. Other barriers include lack of support and inadequate resources provided by the state such as transportation, training, education, and activity coordination. Please view the map below to see where there are currently work requirement waivers.
(Click to enlarge the map)