State will implement Medicaid work requirements until told otherwise

March 30-- Mar. 30--Wisconsin's Medicaid director said the state still plans to implement Medicaid work requirements despite a federal judge earlier this week striking down similar rules in two other states.

The state's course of action means many able-bodied Wisconsinites will eventually need to volunteer or engage in work-related activities or risk losing their medical coverage unless the federal government determines the state's law cannot stand.

"The state law is still the state law," Wisconsin Medicaid director Jim Jones said at a WisPolitics.com forum Thursday on Medicaid expansion. "We are going to follow that state law to the letter, and right now we're waiting for more guidance from (the Centers for Medicare and Medicaid Services) as it relates to our waiver."

WisPolitics.com provided the Wisconsin State Journal with a recording of the event.

Work requirements for Medicaid recipients have been thrown into question in several states after Washington, D.C., District Judge James Boasberg this week blocked such requirements in two states: Arkansas and Kentucky.

Arkansas was the first state to enforce a Medicaid work requirement, and similar rules are in place in Indiana and New Hampshire. The federal government has approved Medicaid work requirements in Arizona, Kentucky, Michigan, Ohio and Wisconsin but they have not yet been implemented.

Boasberg wrote the Trump administration's decision to approve Arkansas' work requirement is "arbitrary and capricious because it did not address ... whether and how the project would implicate the 'core' objective of Medicaid: the provision of medical coverage to the needy."

Wisconsin Republicans in December's post-election extraordinary session voted to enact more stringent rules for some Medicaid recipients, codifying into state law a work requirement for able-bodied, childless adults under age 50 who are insured through the state's BadgerCare Plus program, which is available to those whose incomes fall below the poverty line.

If Medicaid participants don't work or engage in related activities for 48 months, they'll lose coverage for six months, after which they can reapply.

Gov. Tony Evers on the campaign trail had said he'd consider ending the policy, but is now prevented from doing so.

Wisconsin can now also charge monthly premiums of up to $8, along with $8 co-payments for emergency room visits for problems that aren't considered emergencies.

President Donald Trump's administration approved former Gov. Scott Walker's work requirement in the fall, although it rejected Walker's proposal to require drug screening and testing.

Jones said Wisconsin's work requirements are different from the ones struck down in Arkansas and Kentucky, so it's unclear which portions of the requirement could be problematic.

"We think that there's a long road that they're going to go through," Jones said, referring to the determination the federal government must make regarding work requirements in several states.

Wisconsin is set to implement the work requirements in the fall of this year.

So far, only Arkansas and Kentucky are affected by the federal judge's ruling. But Donna Friedsam, health policy programs director of UW-Madison's Population Health Institute, said Boasberg's criticism of work requirements could be applied in other cases that challenge such rules. She said the threat of litigation could also persuade some states to think twice before implementing their requirements.

She said Wisconsin and other states that have had their Medicaid waivers approved may proceed unless the federal government tells them otherwise.

If Wisconsin's requirements were to be challenged in court, however, they could be blocked in the same fashion as those in Arkansas and Kentucky.

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