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.
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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 5.87% APR (with Auto Pay). Variable rate loan rates range from 2.47% APR (with Auto Pay) to 5.87% 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.
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2 Important Disclosures for Laurel Road.
Laurel Road Disclosures
Savings example: average savings calculated based on single loans refinanced from 9/2013 to 12/2017 where borrowers’ previous rates were disclosed. Assumes same loan terms for previous and refinanced loans, and payments made to maturity with no prepayments. Actual savings for individual loans vary based on loan balance, interest rates, and other factors.
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Instant rates mean a delivery of personalized rates for those individuals who provide sufficient information to return a rate. For instant rates a soft credit pull will be conducted, which will not affect your credit score. To proceed with an application, a hard credit pull will be required, which may affect your credit score.
Total savings calculated by aggregating individual average savings across total borrower population from 9/2013 to 12/2017. Individual average savings calculation based on single loans refinanced from 9/2013 to 12/2017 where borrowers’ previous rates were provided. Assumes same loan terms for previous and refinanced loans, and payments made to maturity with no prepayments. Actual savings for individual loans vary based on loan balance, interest rates, and other factors.
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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.
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Citizens Bank Disclosures
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