Some states won't use Medicaid hardship exemption as work requirements near
Some states do not plan to use a federal hardship exemption that would let low-income people in areas with high unemployment keep their Medicaid coverage once new work requirements take effect on 1 January, according to The Guardian.
The exemption is designed to help low-income people keep coverage during hardship. Federal provisions allow exemptions for people who are hospitalized, must travel for medical care, or live in areas affected by disasters or high unemployment.
Under the new requirements, adults who gained coverage through the expansion of Medicaid must complete at least 80 hours per month of work, school, volunteering or other qualifying activity to maintain coverage. The federal Centers for Medicare and Medicaid Services calls the policy the Medicaid Community Engagement Requirement for Certain Individuals, and says it can be met by working, completing community service, or participating in a work program for not less than 80 hours, according to CMS.
New York City has adopted the high-unemployment exemption for the Bronx, where about 200,000 residents would otherwise have been subject to the requirements. Iowa and Missouri are choosing not to take up that exemption despite having counties that would qualify, according to KFF research cited by The Guardian. Missouri says adults ages 19-64 must complete 80 hours per month of work, education or community service to be eligible for Adult Expansion Group coverage, with limited exemptions.
Experts told The Guardian that political and ideological opposition and administrative burden are factors behind decisions not to adopt the exemption.
The requirements are expected to apply to expansion enrollees and certain enrollees under Section 1115 waivers, which allow states to test changes to Medicaid, in 44 states, according to KFF. People who are pregnant, receiving postpartum care, disabled or deemed medically frail are exempt. A coalition of Democratic-led states sued to block the Trump administration rule implementing the requirements, according to Reuters.
