Changes to Medicaid requirements may affect Medicaid planning

by | Jan 26, 2018 | Firm News |

Many people in New Jersey rely on the availability of Medicaid services to allow them to pay for their health care both now or in the future. However, the U.S. Centers for Medicare & Medicaid Services has issued guidelines regarding states’ rights to make it mandatory for certain people who receive Medicaid benefits to work in order to keep receiving benefits. This is a big departure from how the Medicaid and Medicare programs have operated in the past. For example, under these guidelines, if a person does not have a disability and is of a working age, then in order to receive benefits the state could require that person to get a job, volunteer or go back to school. Caregiving may fulfill this requirement.

The CMS cites studies that suggest going to work or performing volunteer activities can keep a person in good health. However, not everyone is on board with this change. Some believe that it would result in many people being left without a source of health insurance. It is probable that these mandates will be challenged in court.

Under the guidelines, states will be given a great deal of flexibility to come up with a program that addresses the fact that additional modifications or exemptions may be needed in some cases. For example, if a person receiving Medicaid cannot fulfill the work requirements because they are sick, because of alcohol or drug abuse or because of high rates of unemployment where they live, states can consider these facts when determining whether to approve someone for benefits. Another exemption could be made for women who are pregnant.

Per the guidelines, states would have to help recipients meet these new work requirements by giving them strategies and getting them connected to the additional training or support — such as transportation or child care — they’d need to work. However, these services could not be funded by Medicaid.

While some say that these guidelines simply make Medicaid services work like other government services do, others believe that a work requirement could leave many otherwise qualifying individuals without any means to pay for health care. In the end, those in the process of Medicaid planning will want to pay attention to this issue, as it could affect them in the future.

Source: CNN Money, “Trump administration allows states to make Medicaid recipients work,” Tami Luhby, Jan. 11, 2018