Trump administration says Wisconsin Gov. Scott Walker can have his Medicaid work requirements

Wisconsin is officially the fourth state to condition Medicaid recipients’ health care on work, even as two other states are currently being sued for their requirements.

The Trump administration approved Gov. Scott Walkers’ long-sought policy on Wednesday, less than a week before election day, when he faces a tough race against Democrat challenger Tony Evers .

The state estimates more than 5,000 will no longer have Medicaid coverage due to Wednesday’s changes. It’s also the only state of the four that have work requirements but didn’t expand Medicaid eligibility to 138 percent of poverty level.

People between ages 19 and 49 who make less than 100 percent of poverty, or about $12,000 annually for a single person, will have to work and report 80 hours a month to keep health coverage. If they fail to report work for 48 consecutive months and don’t qualify for an exemption, they’ll be locked out of coverage for six months. More than 4,100 people in Arkansas lost Medicaid coverage for failing to comply with work requirements for three months.

Medicaid recipients in Arkansas and Kentucky are suing officials for conditioning work on health care, and plaintiffs already scored a victory in the latter.

In addition to work requirements, the administration is allowing Wisconsin to charge $4-8 monthly premiums to people making 50 percent of the federal poverty level. Premiums could be reduced if beneficiaries demonstrate that they’re engaging in “healthy behavior,” such as dieting and exercise or wearing a seatbelt. Should folks fail to pay, they could lose their benefits up to six months. When Indiana required Medicaid recipients to pay premiums, 2,677 individuals  were dropped from the rolls within the first year of implementation.

Medicaid recipients will also have to pay an $8 co-payment if they go to the emergency room for non-ambulatory care.

These changes apply could apply to up to 178,000 people. 

Wisconsin had originally asked the Trump administration to condition drug testing but wasn’t able to get it approved. (Experts have condemned the idea as costly and offensive.) Instead, Medicaid recipients will have to fill out a health risk assignment. Depending on their responses, they can be referred to addiction treatment.

“The vast majority of the comments CMS received were from self-identified Wisconsin citizens who opposed either the demonstration as a whole or certain features of it,” the Trump administration said in its approval letter to Wisconsin officials.

And yet, the administration approved its policy because it “believes the features of this demonstration are worth testing.”

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While Republicans contend Medicaid work requirements are about motivating people to work, data shows that most Medicaid recipients who can work are already working. People who drop coverage do so because of the added red tape or don’t work enough hours due to the industry they’re in.

Walker has had to defend his health record on the campaign trail as he tries for a third term. While he’s propped up the Affordable Care Act (ACA) once , he’s largely worked against it by advocating for repeal and being party to a lawsuit to eliminate the health law — and with it, protections for people pre-existing conditions.

Alternatively, Evers says that, if elected , he would accept the federal Medicaid expansion. The Cook Political Report describes the race as a “Toss Up .”


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