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Top Dems Raise Concern with Administration’s Push for Medicaid Work Requirements

Aug 23, 2018
Press Release
“Perverse Result” Could Eliminate Coverage for Those Who Comply

Washington, DC (Aug. 23, 2018)—Today, Rep. Elijah E. Cummings, the Ranking Member of the House Committee on Oversight and Government Reform, and Rep. Raja Krishnamoorthi, the Ranking Member of the Subcommittee on Health Care, Benefits, and Administrative Rules, sent a letter to the Department of Health and Human Services and the Centers for Medicare and Medicaid Services (CMS) regarding the Trump Administration’s continued push for states to impose work requirements for Medicaid beneficiaries.

“We are writing to express grave concern that recent actions by the Trump Administration to promote new work requirements for Medicaid could cause many low-income Americans and their families to lose their health insurance simply by complying with these new requirements,” the Ranking Members wrote.  “This is a perverse result that even the proponents of these new requirements should oppose.”

On January 11, 2018, the Centers for Medicare and Medicaid Services (CMS) issued guidance to state Medicaid Directors, encouraging them to impose work requirements on Medicaid beneficiaries.  Since then, 11 states have submitted proposals to CMS for review, and other states are in the process of drafting similar proposals, including Oklahoma and South Carolina.

When Congress passed the Affordable Care Act, it authorized states to expand Medicaid eligibility to individuals making up to 138% of the federal poverty line, but 17 states have opted not to do so.

“Proposals for work requirements—especially in these non-expansion states—could result in coverage losses for low-income individuals who become ineligible for Medicaid, but are unable to afford private insurance, the Ranking Members wrote.  “In effect, work requirements may lock these individuals out of affordable coverage.”

The Ranking Members cited the example of Mississippi, which has proposed requiring Medicaid beneficiaries to work at least 20 hours per week.  A mother working 20 hours per week at minimum wage in Mississippi would earn $580 per month.  This would make her ineligible for Medicaid because her monthly earnings would exceed the state’s threshold for Medicaid eligibility by $113. 

Approximately 91% of Medicaid beneficiaries who are parents in Mississippi are mothers, and 71% are black, according to the Center for Children and Families at Georgetown University.

“The disproportionate impact that these coverage losses will have on black mothers in particular raises serious concerns that may implicate Title VI of the Civil Rights Act, which prohibits discrimination on the basis of race, color, and national origin in programs and activities receiving federal financial assistance,” the Ranking Members wrote.

The Ranking Members requesting documents and information on any impact research, decision making, and other communications surrounding the decision to impose work requirements by September 6, 2018.  They also requested a staff briefing.

Click here to read today’s letter.

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115th Congress