Donald Trump listens to Kentucky Governor Matt Bevin speak, during a prison reform roundtable in the … [+]
A general election Tuesday in Kentucky for the state’s governorship could bring an end to Trump administration and Republican efforts to implement Medicaid work requirements in the state and beyond.
Requiring poor patients covered by Medicaid health insurance to work has been a brainchild of conservative Republicans and espoused most strongly by Gov. Matt Bevin, the GOP governor up for re-election.
Bevin has said the lack of community engagement and work requirements “sets a bad precedent” and creates “a sense of entitlement and expectation, and it sets a bad example for next generations of children who see their parents not going to work, and working the system.”
But studies show most Americans covered by Medicaid are already working. And Bevins’ Democratic opponent, Andy Beshear, the current Kentucky attorney general, has used the costly bureaucratic implementation of Medicaid work requirements successfully against Bevin in the race. The latest polls show the Democrat Beshear in a tight race with the controversial Bevin.
“This governor’s expanded Medicaid waiver is cruel,” Beshear has said, vowing to rescind Bevin’s attempt to implement work requirements via a federal waiver granted by the Trump administration. “It’s shown in Arkansas that the people it’s going to kick off their coverage are people who are already working. It just creates bureaucratic red tape and ultimately tears health care away from people.”
Medicaid work requirements have been controversial and whether they are even legal is before a federal appeals court after being struck down by lower courts already. What’s more, the cost to implement Medicaid work requirements has been running into the hundreds of millions of dollars in Kentucky alone including a company hired to implement them and reports by financial agencies like Fitch Ratings also outlining administrative hassles and expensive new layers of government bureaucracy.
“Bevins sabotaged his own re-election prospects with his idiotic Medicaid requirements,” says John Gorman, a healthcare consultant who worked in the Clinton administration as Assistant Director, Office of Managed Care at HCFA, now known as the Centers for Medicare & Medicaid Services.
“They’ve never been shown to work except as a weaponized paperwork to kick people off the program,” Gorman says. “Other Red States’ work rules are getting crushed in court and many like Indiana (last week) are now running like scalded dogs.”
To be sure, Indiana last week suspended its effort to implement Medicaid work requirements that would have required “those not qualifying for exemptions to report 20 hours a month of work or related activity or face coverage loss after Dec. 31,” Indiana media reports last week said.
It was a particular political blow to Seema Verma, the Donald Trump-appointed head of the Centers for Medicare & Medicaid Services (CMS). Verma also worked on health policy for Mike Pence when he was governor of Indiana.
The Trump administration continues to back Medicaid work requirements. In setting a new policy last year, CMS said it would “support state efforts to test incentives that make participation in work or other community engagement a requirement for continued Medicaid eligibility.”