Kentucky Becomes First State To Require Work For Medicaid Recipients

On Friday, Kentucky became the first state with federal approval to implement a so-called work requirement for Medicaid recipients. The commonwealth is one of 10 states, including Indiana, that have requested approval from the federal government for such a provision.

The new rule, to be rolled out in July, would mandate able-bodied Kentuckians on Medicaid to work or volunteer 20 hours per week.

Kentucky was one of the 32 states that expanded Medicaid, the health insurance program traditionally covering children, the elderly and disabled, under the Affordable Care Act. Kentucky’s expansion brought health coverage to more low-income adults, but the state’s Republican Governor, Matt Bevin, has expressed his dislike for the expanded program.

However, Bevin has said he would support for the state’s Medicaid expansion with limitations, such as a work requirement.

Bevin said the waiver will be “transformational.”

“Able-bodied Kentuckians, they want the dignity associated with able to earn and have engagement in the very things that they are receiving,” he said.

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Experts, however, aren’t as pleased. The Center for Children and Families at Georgetown University, citing the state’s own projections, said the waiver provision could disqualify nearly 100,000 Kentuckians from Medicaid in the next five years.

“There’s a lot of concern in my mind that if folks only get 15 hours that week, how are they going to find an extra five hours of work, or how are they going to find five hours of volunteer opportunities?” said Kentucky Center for Economic Policy researcher Dustin Pugel.

The announcement comes a day after federal Centers for Medicare and Medicaid Services issued a statement it would approve requests for work requirements (with certain limitations.)

Indiana submitted a similar request, expected to be approved in the near future.

Milliman, an Indianapolis-based actuarial firm hired by the state to evaluate its program, predicts just under 133,000 Hoosiers on the state's Medicaid expansion HIP 2.0 would be subject to the work requirement. Of that number, about 25 percent would lose coverage because they don’t comply with the work requirement.

According to the Kaiser Family Foundation, 60 percent of the non-disabled, adult Medicaid population works either part- or full-time.

This story was produced by Side Effects Public Media, a reporting collaborative focused on public health.