On March 27, Judge James Boasberg stopped Kentucky and Arkansas from imposing work requirements on people enrolling in the Medicaid expansion program. The judge, who struck down work reporting requirements in Kentucky once before, said that the Trump administration ‘failed to justify that adding employment conditions and other changes to Medicaid…advanced Medicaid’s basic purpose of providing health coverage. Medicaid’s stated purpose is to enable each state, as far as practicable, “to furnish…medical assistance” to individuals “whose income and resources are insufficient to meet the costs of necessary medical services.”
Similar requirements to report work were approved for Ohio by the Centers for Medicare and Medicare (CMS) on March 15, 2019, and are set to go into effect Friday, January 1, 2021. In Ohio, a person who would qualify for Medicaid health care coverage because of low income would be required to report work or service, meet an exemption, or lose coverage.
Mandated for submission by the Ohio General Assembly, Ohio’s waiver request was submitted to the Trump administration in April 2018, and is expected to result in up to 36,000 Ohioans losing their Medicaid eligibility. According to the Ohio Department of Medicaid, 58% of expansion enrollees already work, but they are low-wage jobs that don’t offer health care.
The Ohio Academy of Family Physicians objected to the waiver’s approval. In 2018, OAFP then-President Don Mack, MD, submitted the following comments to CMS in behalf of the OAFP: “As primary care physicians serving on the front lines of patient care in Ohio, we know firsthand that approval of Ohio’s waiver application would be a devastating blow to progress made in providing health care coverage to Ohio’s Medicaid and other low-income populations. This waiver, if approved, reverses gains made when Medicaid was expanded and care was improved by transitioning services from expensive hospital emergency departments to less expensive outpatient settings and is a huge step backward in achieving the American Academy of Family Physicians’ long-standing goal of achieving health care coverage for all. “
The state is projecting implementation of the waiver in 2021.