Arizona Requests Medicaid Work Requirements and Lifetime Eligibility Limits

Arizona is asking the federal government to allow it to add work requirements and lifetime eligibility limits for some adults enrolled in Medicaid, Stateline reported today. The request, which is in the form of a Section 1115 waiver request, is required under laws passed by the 2015 Arizona State Legislature. Senate Bill 1475 and Senate Bill 1092 require the governor to submit the waiver but do not link continuation of the current Medicaid expansion to the waiver’s approval. Former Gov. Jan Brewer vetoed nearly identical legislation the year before, the Arizona Daily Star reported in March 2015.

Manatt Phelps & Phillips has released an analysis of the waiver request, submitted to the federal government on August 18, 2015. The waiver seeks to institute premiums for all enrollees, establish co-payments for non-emergency use of emergency departments and eliminate non-emergency transportation benefits. Besides the work requirements and five-year benefit limit, the waiver seeks to disenroll individuals who fail to report income or work status change and charge premiums and co-pays for individuals with income below the federal poverty level -- all policy changes not previously allowed by the federal government. 

The Arizona waiver request may prove to be an exercise in futility as long as Barack Obama is president. Indiana requested work requirements in its original 1113 waiver but was forced by the Obama administration to drop the requirement during negotiations. Also Medicaid is an entitlement program -- eligible individuals are guaranteed benefits and states are guaranteed federal matching funds under existing law regardless of budgetary impacts on the state or the federal government. The Arizona legislature, in requiring that a waiver request be submitted annually, seems to be betting that a new Republican administration might be more favorably inclined toward their policy proposals.