In spite of all of the president’s campaigning as an advocate of the “forgotten” people of the United States, he has taken repeated aim at their interests, including through his attacks on the nation’s health care system.
Early in his administration, he sought to repeal the Affordable Care Act, a measure that has provided health coverage to tens of millions of people through such mechanisms as an expansion of Medicaid. The GOP’s efforts to completely repeal the law failed.
That initial failure has not stopped the Trump administration in its attempts to shape the national health care system more to its liking. For instance, included in the tax reform bill that Trump recently signed into law was a repeal of the ACA’s individual mandate, which is expected to threaten the very stability of the ObamaCare market through allowing some to no longer participate in it.
Now, there are reports that the Trump Administration is preparing for a new move to undercut the nation’s health care system, formally allowing states to impose work requirements on Medicaid recipients.
In the past, the federal government has denied requests from states for an allowance to impose work requirements on Medicaid recipients, but now, guidelines for approving those requests are expected to soon be issued.
Current administrator of the Centers for Medicare and Medicaid Services Seema Verma has cast the idea of imposing work requirements for Medicaid recipients — referred to by her as requirements for “community engagement” — as something for their benefit.
‘For people living with disabilities, CMS has long believed that meaningful work is essential to their economic self-sufficiency, self-esteem, well-being and improving their health. Why would we not believe that the same is true for working age, able-bodied Medicaid enrollees?’
It’s simply not as though every “working age, able-bodied” enrollee in Medicaid is sitting around milking the system. That’s the point of the program — to provide health coverage for lower income people who can’t, for whatever reason, obtain coverage otherwise, even though it’s not as though this is the first time that the Trump admin has taken aim at the program.
The Kaiser Family Foundation found that nearly three million of those who were enrolled in Medicaid but not working in 2016 were in such a position because of caring for a family member. These lower income people likely have little capability to provide for their ill loved one outside of their own personal care, but if the Trump administration has its way, these people will be penalized for the fact that there are only 24 hours in a day and caregiving can easily be a full time job.
Concurrently, about one and a half million of the 9.8 million non-elderly Medicaid enrollees who weren’t working in 2016 said that they weren’t doing so because they were in school. Are these people expected to abandon their schooling so that they can spend an extraordinary amount of time working just to get by? Alternatively, perhaps they are expected to simply get along fine without health coverage.
States including Arkansas, Arizona, Indiana, Kentucky, Maine, New Hampshire, Utah, and Wisconsin have all requested to be allowed to impose work requirements, with Verma actually announcing that the Trump Administration intended to approve work requirements late last year.
However, the Trump Administration has apparently lagged in actually fulfilling that promise thanks to concerns about potential lawsuits. Besides the merits of this particular case, the Trump administration has not had the greatest record when it comes to defending itself in court.
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