Medicaid

While state policy makers frequently express concern about the increasing percentage of state funds required to fund their Medicaid programs, the programs bring in large amounts of federal dollars to states. Across all states, two thirds of all federal grant funds received by states in 2017 are for Medicaid health services for low-income, disabled and elderly individuals. 

Jason Helgerson, leaving his job this week as New York Medicaid director after 7 years,  blogged in Health Affairs about the lessons he learned.  He says in the post that when his New York experience is combined with the previous 4 years as Wisconsin Medicaid director, he is the nation’s longest-serving Medicaid director. The average tenure of a Medicaid director, according to Helgerson, is 19 months.

Earlier this week, the head of the U.S. Centers for Medicare and Medicaid, Seema Verma, travelled to Arkansas and signed a waiver request to require Medicaid enrollees to work or prepare for a job. The work requirement will only impact the expansion population, specifically childless adults 19 to 49 years old. They will be required to work or participate in activities such as volunteering or vocational training for 20 hours per week. The requirement will be phased in between June and September 2018.

The idea of requiring able-bodied adults to work or be actively seeking it as a condition for government assistance is certainly not new, but its application to Medicaid is as of January, when the Trump administration began approving some states’ applications to impose work rules as a condition of eligibility for this public health insurance program.