Women who are pregnant or immediately postpartum, parents of young children, and veterans with disabilities are some of the groups that the Donald Trump Administration now says may be exempt from new requirements that restrict eligibility for public health insurance.
The new guidelines, released this Monday by the Centers for Medicare and Medicaid Services, finally explain how states should apply adjustments established last year by the Trump Administration through its mega tax law.
These adjustments mean that, starting this Monday, in order to continue having coverage, people would have to work, study or do community service at least 80 hours a week. This had worried people who care for family members with a disability or medical situation, who normally have no room to work more than part-time to be able to provide that care.
But the new guidelines do specify that those people could qualify for exemptions to the 80-hour work requirement. People who are “medically fragile” due to conditions such as cancer may also be exempt.
“If politicians really want to encourage work, providing unrestricted access to Medicaid is a good start.”
analysis from the American Catholic Health Association.
Since Trump’s mega tax law transferred much of the responsibility of Medicare or Medicaid to the states, the guidelines establish that state authorities will have the discretion to determine under what medical conditions the exemption from the 80-hour requirement can be requested.
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In states that are already enforcing this requirement, such as Nebraska, the local Department of Health has established comprehensive lists with up to 300 possible factors.
To request the exemption, the Centers for Medicare and Medicaid will allow people to declare if they are eligible during the first year without having to provide all the documentation that supports that they do have a medical condition or that they have issues such as caring for a family member that makes it difficult for them to complete the 80 hours.
However, federal officials said that starting in 2028 all states will be required to verify that whoever declares an exemption does meet those characteristics.
They said the initial flexibility is so that states have time to build the mechanism of their preference to perform those verifications, such as certain databases.
“We are providing a compassionate and accommodating approach, but there is no need to be complacent,” Mehmet Oz, head of the Centers for Medicare and Medicaid, said at a conference Monday.
Larry Levitt, executive vice president of health policy issues at the nonpartisan, nonprofit group KFF, welcomed the initial flexibility to self-declare conditions. He said this makes it less likely that people on Medicaid will end up losing their insurance during the first year of transitioning to the new system.
KFF had estimated that up to 5 million people could otherwise lose their health coverage by 2034 under Trump’s scheme, largely because of difficulties with paperwork and administrative issues, and not because they do not meet the work requirement.
However, Levitt said one year still may not be enough for states to have “adequate systems” to conduct waiver verifications.
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The Trump administration says the new work-hour requirements will encourage more people to work, because Republican officials say having certain social safety nets discourages people from having jobs.
However, several analyzes have shown that this myth that there is “laziness” on the part of social security users does not coincide with the facts. To begin with, several of the beneficiaries are young children who should not be working anyway, and official data shows that only about 1% of the US population falls into the group of people with Medicaid who do not work 80 hours a week.
“If politicians really want to encourage work, providing unrestricted access to Medicaid is a good start, because individuals who do have insurance through this means are more likely to look for a new or better job,” according to the Catholic Health Association of the United States (CHA), which groups hundreds of hospitals in the country.
