For the first time in the history of the program, the federal government will allow states to impose work requirements for access to Medicaid.
On Jan. 11, the Centers for Medicare & Medicaid Services (CMS) announced guidance for states to test “community engagement” for Medicaid recipients.
Ten states have submitted proposals for Medicaid work requirements so far. Several others are considering doing so as well.
So what could this new guidance from the Trump administration mean for the 72.5 million Americans receiving Medicaid benefits and the millions more who will need it in the future?
Here’s what we know so far.
Some states will impose work requirements for Medicaid
As a nationwide public health insurance program for low-income people, Medicaid provides coverage to one in five Americans. In recent years, many states have expanded Medicaid coverage to include more of the nonelderly population, including the working poor and adults with disabilities.
The new guidance, however, could reverse this trend by allowing states to impose work or “community engagement” requirements for Medicaid coverage. It would be up to each state to implement these measures.
Kentucky, for example, is proposing that nondisabled people between 19 and 64 must work at least 20 hours per week to qualify. They also could fulfill this requirement through volunteer work, job training, education, or caregiving.
According to the new guidance, states should permit exemptions, particularly for pregnant women, full-time students, caretakers, and adults with disabilities. It also encourages an exemption for people who are deemed “medically frail.”
However, the Kaiser Family Foundation found that the vast majority of non-Supplemental Security Income Medicaid enrollees were unemployed for those reasons. Among such enrollees, 90 percent were unemployed because they were ill or disabled, retired, taking care of their home or family, or attending school.
Although each state could design these requirements differently — and some states might not add them at all — this new approach marks the first time Medicaid would require proof of work in exchange for health coverage.
Critics say new rules will strip people of crucial benefits
Seema Verma, the administrator of CMS, has lauded the new guidance as a step forward for Medicaid and public health.
— CMS Administrator (@SeemaCMS) January 11, 2018
But critics suggest the move could leave many people uninsured.
In a statement for the Center for American Progress, Executive Vice President for External Affairs Winnie Stachelberg said, “Ripping away health care from people who have lost their jobs will not create a single job, raise anyone’s wages, or help anyone who is struggling to find work.”
“Instead,” she continued, “it kicks people while they’re down — taking away health care from unemployed or underemployed workers when they need it most.”
The Southern Poverty Law Center also has condemned the new Medicaid guidelines from the Trump administration as a step backward for public health.
If the president seriously wants to improve our health care system, he should work harder to fulfill his campaign promise of health care for everyone, not only those who can afford it. https://t.co/ja1B7wyfVp pic.twitter.com/OsqrCd085I
— Southern Poverty Law Center (@splcenter) January 11, 2018
Anyone who loses their Medicaid benefits might be hard-pressed to find an affordable alternative. Without employer-sponsored health insurance, you could enroll in a plan through HealthCare.gov during open enrollment or “special enrollment.”
According to the U.S. Department of Health and Human Services, about 78 percent of enrollees paid less than $100 per month for their plans in 2016. But that amount could be unaffordable without a regular income.
Besides looking into alternative health care plans, another way to protect yourself is to stay on top of state requirements. If you’re not able to meet the work requirement, you could potentially qualify through other activities, such as volunteering.
Although the work requirements might be flexible, some Americans could have trouble showing they’re exempt if, for example, they can’t show a diagnosed disability. Extra red tape also could prevent some Americans from applying for Medicaid in the first place.
If you fall into a murky gray area, hold on to any documentation that could support your eligibility or prove you’re exempt from new state requirements.
Stay informed about upcoming changes to Medicaid coverage
In its May 2017 budget proposal, the Trump administration stated its intention to allow states to manage how they administer Medicaid programs.
Yesterday’s guidance from Verma and the CMS fulfilled that promise. Many people expect state proposals to be approved within a matter of days.
If you rely on Medicaid for health care benefits — or care for someone who does — stay informed about your state’s eligibility requirements so you can protect your benefits.
And if you’d like to take action, call the U.S. Capitol switchboard at (202) 224-3121 and ask to speak with your state representative.
Interested in refinancing student loans?Here are the top 6 lenders of 2018!
|Lender||Variable APR||Eligible Degrees|
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1 Important Disclosures for Earnest.
To qualify, you must be a U.S. citizen or possess a 10-year (non-conditional) Permanent Resident Card, reside in a state Earnest lends in, and satisfy our minimum eligibility criteria. You may find more information on loan eligibility here: https://www.earnest.com/eligibility. Not all applicants will be approved for a loan, and not all applicants will qualify for the lowest rate. Approval and interest rate depend on the review of a complete application.
Earnest fixed rate loan rates range from 3.89% APR (with Auto Pay) to 7.89% APR (with Auto Pay). Variable rate loan rates range from 2.47% APR (with Auto Pay) to 6.97% APR (with Auto Pay). For variable rate loans, although the interest rate will vary after you are approved, the interest rate will never exceed 8.95% for loan terms 10 years or less. For loan terms of 10 years to 15 years, the interest rate will never exceed 9.95%. For loan terms over 15 years, the interest rate will never exceed 11.95% (the maximum rates for these loans). Earnest variable interest rate loans are based on a publicly available index, the one month London Interbank Offered Rate (LIBOR). Your rate will be calculated each month by adding a margin between 1.82% and 5.50% to the one month LIBOR. The rate will not increase more than once per month. Earnest rate ranges are current as of Month/Day/Year, and are subject to change based on market conditions and borrower eligibility.
Auto Pay discount: If you make monthly principal and interest payments by an automatic, monthly deduction from a savings or checking account, your rate will be reduced by one quarter of one percent (0.25%) for so long as you continue to make automatic, electronic monthly payments. This benefit is suspended during periods of deferment and forbearance.
The information provided on this page is updated as of 08/21/18. Earnest reserves the right to change, pause, or terminate product offerings at any time without notice. Earnest loans are originated by Earnest Operations LLC. California Finance Lender License 6054788. NMLS # 1204917. Earnest Operations LLC is located at 302 2nd Street, Suite 401N, San Francisco, CA 94107. Terms and Conditions apply. Visit https://www.earnest.com/terms-of-service, email us at email@example.com, or call 888-601-2801 for more information on ourstudent loan refinance product.
© 2018 Earnest LLC. All rights reserved. Earnest LLC and its subsidiaries, including Earnest Operations LLC, are not sponsored by or agencies of the United States of America.
2 Important Disclosures for Laurel Road.
Laurel Road Disclosures
APR stands for “Annual Percentage Rate.” Rates listed include a 0.25% EFT discount, for automatic payments made from a checking or savings account. Interest rates as of 11/8/2018. Rates subject to change.
Variable rate options consist of a range from 3.27% per year to 6.09% per year for a 5-year term, 4.64% per year to 6.14% per year for a 7-year term, 4.69% per year to 6.19% per year for a 10-year term, 4.94% per year to 6.44% per year for a 15-year term, or 5.19% per year to 6.69% per year for a 20-year term, with no origination fees. APR is subject to increase after consummation. The variable interest rate will change on the first day of every month (“Change Date”) if the Current Index changes. The variable interest rates are based on a Current Index, which is the 1-month London Interbank Offered Rate (LIBOR) (currency in US dollars), as published on The Wall Street Journal’s website. The variable interest rates and Annual Percentage Rate (APR) will increase or decrease when the 1-month LIBOR index changes. The variable interest rates are calculated by adding a margin ranging from 0.98% to 3.80% for the 5-year term loan, 2.35% to 3.85% for the 7-year term loan, 2.40% to 3.90% for the 10-year term loan, 2.65% to 4.15% for the 15-year term loan, and 2.90% to 4.40% for the 20-year term loan, respectively, to the 1-month LIBOR index published on the 25th day of each month immediately preceding each “Change Date,” as defined above, rounded to two decimal places, with no origination fees. If the 25th day of the month is not a business day or is a US federal holiday, the reference date will be the most recent date preceding the 25th day of the month that is a business day. The monthly payment for a sample $10,000 loan at a range of 3.27% per year to 6.09% per year for a 5-year term would be from $180.89 to $193.75. The monthly payment for a sample $10,000 loan at a range of 4.64% per year to 6.14% per year for a 7-year term would be from $139.65 to $146.76. The monthly payment for a sample $10,000 loan at a range of 4.69% per year to 6.19% per year for a 10-year term would be from $104.56 to $111.98. The monthly payment for a sample $10,000 loan at a range of 4.94% per year to 6.44% per year for a 15-year term would be from $78.77 to $86.78. The monthly payment for a sample $10,000 loan at a range of 5.19% per year to 6.69% per year for a 20-year term would be from $67.05 to $75.68.
However, if the borrower chooses to make monthly payments automatically by electronic funds transfer (EFT) from a bank account, the variable rate will decrease by 0.25%, and will increase back up to the regular variable interest rate described in the preceding paragraph if the borrower stops making (or we stop accepting) monthly payments automatically by EFT from the designated borrower’s bank account.
3 Important Disclosures for SoFi.
4 Important Disclosures for LendKey.
Refinancing via LendKey.com is only available for applicants with qualified private education loans from an eligible institution. Loans that were used for exam preparation classes, including, but not limited to, loans for LSAT, MCAT, GMAT, and GRE preparation, are not eligible for refinancing with a lender via LendKey.com. If you currently have any of these exam preparation loans, you should not include them in an application to refinance your student loans on this website. Applicants must be either U.S. citizens or Permanent Residents in an eligible state to qualify for a loan. Certain membership requirements (including the opening of a share account and any applicable association fees in connection with membership) may apply in the event that an applicant wishes to accept a loan offer from a credit union lender. Lenders participating on LendKey.com reserve the right to modify or discontinue the products, terms, and benefits offered on this website at any time without notice. LendKey Technologies, Inc. is not affiliated with, nor does it endorse, any educational institution.
5 Important Disclosures for CommonBond.
Offered terms are subject to change. Loans are offered by CommonBond Lending, LLC (NMLS # 1175900). If you are approved for a loan, the interest rate offered will depend on your credit profile, your application, the loan term selected and will be within the ranges of rates shown.
All Annual Percentage Rates (APRs) displayed assume borrowers enroll in auto pay and account for the 0.25% reduction in interest rate. All variable rates are based on a 1-month LIBOR assumption of 2.28% effective October 10, 2018.
6 Important Disclosures for Citizens Bank.
Citizens Bank Disclosures
|2.47% – 6.99%3||Undergrad & Graduate|
|2.57% – 6.97%1||Undergrad & Graduate|
|2.51% – 8.09%4||Undergrad & Graduate|
|3.02% – 6.44%2||Undergrad & Graduate|
|2.50% – 7.24%5||Undergrad & Graduate|
|2.79% – 8.39%6||Undergrad & Graduate|