Healthcare providers accepting Medicaid may see their patient volume decrease in coming months, the result of a plan recently approved by the federal government to grant states the authority to impose work requirements on Medicaid recipients. Seema Verma, Centers for Medicare and Medicaid Services Administrator, claims that the recent expansion of Medicaid has stretched the program’s resources too thin and that it is time to refocus the program on “deserving Americans.”
Medicaid currently serves about 75 million low-income individuals, allowing them to access fundamental healthcare services. Verma has proposed a plan to reduce the number of Medicaid recipients by allowing states to implement work requirements on able-bodies adults wishing to enroll in the program. “Her goal for Medicaid is to move people out of the program by getting them into jobs that offer coverage or provide enough income so they buy it on their own.”
This redefined approach to Medicaid facilitation is in sharp contrast to the Obama administration’s stance that, “work requirements [are] inconsistent with Medicaid’s mission of providing medical assistance to low-income people.” The consequences of work requirements will be far reaching, affecting many Medicaid enrollees, their families, communities, and healthcare providers as well.
Healthcare providers should be concerned about potential Medicaid work requirements because many of their patients will not be able to fulfill them. Here are some reasons why:
1. They can’t work because of something other than their health.
The work requirement would impose barriers to access on those who will be unable to meet the requirement due to various non-health-related factors, such as child care responsibilities, language barriers, educational limitations, or criminal histories which prevent them from gaining employment. These factors, which have no relation to health and well-being, would immediately disqualify individuals from Medicaid eligibility, ultimately eliminating their access to healthcare.
Additionally, it is important to note that, “most nondisabled adults on Medicaid already work”, but are still unable to secure health insurance. While supporters of the work requirement have actively portrayed many Medicaid recipients as accustomed to dependence, they have failed to acknowledge that most of the recipients are the hard-working poor.
2. They can’t work because of their health.
While Verma claims that individuals on disability will be exempt from work requirements, many current Medicaid recipients have invisible chronic illnesses that are often denied disability benefits. Approval for disability benefits can be extremely difficult because the standard is set too high. Many individuals are actively unable to work because their health conditions are not approved or recognized for disability. This means that individuals dependent on Medicaid who are disabled, but not receiving disability benefits would be barred from accessing necessary healthcare services. Not only could a cessation of health services “make individuals sicker,” but it could make people “less likely to hold down jobs.”
3. It doesn’t matter why they don’t or can’t work.
Requiring Medicaid recipients to work will not make them get a job, but it will make them disengage entirely from healthcare services. Focusing in on the issue, it becomes clear that it really does not matter why individuals do not or cannot work. What matters is that millions dependent of Medicaid rely on services such as substance abuse treatment, pain management, and mental healthcare, among thousands of additional services. For instance, as the opioid epidemic runs rampant through our country and our communities, we simply cannot afford to deny a single person access to potentially life-saving substance abuse or mental healthcare. What we need to do is work hand-in-hand with patients to manage and resolve their healthcare needs. Working in exchange for healthcare is simply not the answer.
Work requirements have the potential to take a heavy toll on healthcare providers whose practices are financially dependent on serving Medicaid recipients. Fortunately, healthcare providers have a unique positionality and are able to advocate for their patients in addition to providing them health services. To learn how you can oppose and combat the effects of Medicaid work requirements in your profession or practice, contact Jackson LLP.
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