“‘Able-bodied’ seniors and family caregivers face changes in participating states.”
Many lower-income Americans see Medicaid as their lifeline to health care. This includes "older nonelderly" adults from 50 to 64. That’s an age range when chronic health conditions and mobility issues are common, says US News & World Report in its recent article, “How Medicaid Work Requirements Could Hurt Older Americans.” There are others who use Medicaid benefits to help as family caregivers.
The Centers for Medicare & Medicaid Services announced in January that states can apply for waivers to implement work requirements for people who receive Medicaid benefits. This will impact some older Americans.
The waivers have been approved in three states and are pending approval in others. Age limits vary for who might have to fulfill work or "community engagement" requirements for up to 80 hours a month. In Kentucky, Medicaid recipients are exempt at 64. In Indiana, it’s 60, and in Arkansas, 50 is the threshold. Some other states are looking to implement work requirements. They include Arizona, Kansas, Maine, Mississippi, New Hampshire, Utah and Wisconsin.
Beth Kuhn, commissioner of the Kentucky Department of Workforce Investment, notes that most people on Medicaid also receive Supplemental Nutrition Assistance Program (SNAP) benefits—also known as food stamps. For those 80% of Medicaid recipients, she says, work requirements don't apply after age 49.
Community engagement is the prime focus of the new requirements, which entails four facets: volunteering, training and education, work, and caregiving of a family or community member in need.
There are many who are excluded from the requirement, and one group is the medically frail. Medical frailty would be determined by an eligibility specialist. However, it’s not clear now how chronic medical conditions impacting many beneficiaries, like asthma, diabetes, heart disease, high cholesterol, and hypertension, will be considered.
The Southern Poverty Law Center, National Health Law Program, and Kentucky Equal Justice Center filed a federal class-action lawsuit on behalf of a group of Kentucky residents receiving Medicaid, challenging the legality of Kentucky's plan. Another brief was jointly filed by groups including Justice in Aging, AARP, AARP Foundation, the National Academy of Elder Law Attorneys (NAELA) and the Disability Rights Education and Defense Fund.
Reference: US News & World Report (April 20, 2018) “How Medicaid Work Requirements Could Hurt Older Americans”