CMS overhaul of Medicaid may face legal challenges

November 8, 2017

CMS, Industry Updates, Medicaid

By Virgil Dickson

The CMS will approve requests coming in from various states to impose work requirements on Medicaid enrollees, according to CMS Administrator Seema Verma. While only a handful of states have asked for waivers for the requirement, others could follow.

“These are individuals who are physically capable of being actively engaged in their communities, whether it be through working, volunteering, going to school or obtaining job training,” Verma said at the National Association of Medicaid Directors conference on Tuesday. “Let me be clear to everyone in this room, we will approve proposals that promote community engagement activities.” Verma said the agency will adjust its workflow to accommodate those requests.

The move could drastically change the direction of Medicaid. But experts say the CMS will likely face legal challenges to the waivers if granted. 

Verma’s remarks come days after New Hampshire became the latest state to submit its request to impose work requirements in its Medicaid enrollees. Arkansas, Arizona, Indiana, Kentucky, Maine, Utah and Wisconsin also have pending requests waiting for approval.

Given Verma’s past experience as a consultant drafting these types of policies for states like Indiana, it was curious that the agency hadn’t already approved the requests. Kentucky has been waiting for over a year for a response.

Opponents of the work requirement policy say it’s a contradiction of the purpose of Medicaid, which was established by Congress in 1965 to provide coverage to low-income people. Read more…