After Kansas plan, Trump official open to Medicaid work rules

Nov. 07--TOPEKA -- The federal government on Tuesday announced a new openness to Medicaid work requirements like those proposed in Kansas.

The Centers for Medicare and Medicaid Services, the federal agency that authorizes Kansas's privatized Medicaid program called KanCare, unveiled a "significant shift from prior policies" that includes a willingness to consider work requirements.

"Every American deserves the dignity and respect of high expectations and as public officials we should deliver programs that instill hope and say to each beneficiary that we believe in their potential," CMS administrator Seema Verma said in a speech in Virginia, according to a statement from the agency.

"CMS believes that meaningful work is essential to beneficiaries' economic self-sufficiency, self-esteem, well-being, and health of Americans."

Kansas outlined its proposal for the next version of KanCare in October. The state's plan would include work requirements on some recipients. Some 12,000 people would be affected, the state said, though it's unclear how many are not currently working.

President Trump's administration has expressed interest in work requirements previously. But Verma's remarks, coming after Kansas's proposal, represent a new, clear signal that the administration will likely approve work requirements.

Kansas is not alone among states in proposing a work requirement. The federal government has never authorized a Medicaid work requirement before, however.

Verma's speech indicates that's likely to change.

"Our vision for the future of Medicaid is to reset the federal-state relationship and restore the partnership, while at the same time modernizing the program to deliver better outcomes for the people we serve," Verma said.

Implementation of work requirements would almost certainly trigger litigation from opponents. They argue work requirements are designed to reduce access to care.

"It's illegal. It's in conflict with existing federal law," said David Jordan, director of the Alliance for a Healthy Kansas.

Work requirement supporters -- including Gov. Sam Brownback's administration -- say the requirements boost the recipients' quality of life.

More than 400,000 people are enrolled in KanCare. The work requirements proposed by the Brownback administration would follow work requirements already in place for other welfare programs.

Those requirements call for 20 hours of work a week. Pregnant women, individuals with disabilities, those in long-term care and those caring for children under six would be exempt. The proposal includes other additional exemptions as well.

In general, parents with children older than six will be affected by the work requirements. While the group affected is estimated to include about 12,000 people, KanCare officials have said some of those individuals are already required to work because of enrollment in other welfare programs.

"KanCare members will be able to receive more tailored, comprehensive care than ever before," Susan Mosier, director of the Kansas Department of Health and Environment, said in a statement.

"We have met with and listened to our KanCare members and advocates to address not only their health needs, but also their goals of becoming independent and living a better life."

Kansas is seeking a long-term reauthorization of KanCare, which has been in place since 2013. Under KanCare, companies called managed care organizations contract with the state to provide health coverage.

In January, CMS denied a temporary one-year extension of the program, saying the program was "substantially out of compliance" with federal law and regulations, after investigators reviewed the program in October 2016. The agency approved a one-year extension earlier this month after Kansas took steps to correct problems found by CMS.

Public comment sessions are scheduled throughout the state this month, including one in Wichita on November 16 at the Mariott, 9100 Corporate Hills Drive. The hearing will be 2 p.m. to 4 p.m. and 6 p.m. to 8 p.m.

Jonathan Shorman: 785-296-3006, @jonshorman

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