Baker: Massachusetts won’t impose Medicaid work requirement

Jan. 11--Gov. Charlie Baker's top health official said it's unlikely the administration will seek a waiver to establish work requirements for Medicaid recipients after President Trump opened the door to the major policy shift this morning.

Health and Human Services Secretary Marylou Sudders said such a requirement has "not been something we've been pursuing" and indicated she likely won't seek to add it amid other efforts to reshape the state's Medicaid program, known as MassHealth.

"I see this as CMS giving states that are looking for flexibility, flexibility," Sudders said, using the acronym for the Centers for Medicare and Medicaid Services. "Whether we choose that flexibility or not in Massachusetts, you know, probably not. We continue to want people to have healthcare coverage."

She later added, "I'm not at this time thinking I'm going to be heading in that direction."

In a statement released this afternoon, Baker's office said it "does not support applying work requirements to the MassHealth program."

Ten states, including Maine and New Hampshire, had sent proposals to the federal government seeking the controversial change. The requests prompted CMS to issue today's guidance about how to obtain federal approval for waivers imposing work requirements on "able-bodied" adults.

Currently, people are not legally required to hold a job to be on Medicaid, and advocates for low-income adults have already raised concerns that a change could cut off an untold number of people from their health insurance.

"Medicaid needs to be more flexible so that states can best address the needs of this population," Seema Verma, the head of CMS, said in a statement. "Our fundamental goal is to make a positive and lasting difference in the health and wellness of our beneficiaries."

In Massachusetts, MassHealth covers 1.9 million people and has grown into a $16 billion program, accounting for 40 percent of the entire state budget. The growth has prompted Baker and lawmakers to seek out a range of reforms to scale back costs, including in 2016, when the administration received a so-called 1115 federal waiver, worth $52.4 billion over five years, to reshape its program.

Sudders said she will review the guidance issued today and "see what it has to offer." But she said a work requirement hasn't been on her radar "because I've been completely focused on restructuring the Medicaid program and making it sustainable for Massachusetts."

"I give CMS some credit for listening to 10 states," she said. "They're trying to be responsive to states."

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