Trump administration poised to make move on Medicaid work requirements

In another sign that it’s embracing nonlegislative means of altering healthcare policy, the Trump administration is poised to issue new guidelines that pave the way for states to enact Medicaid work requirements.

Sources told The Hill that the guidelines would set the conditions for allowing states to require able-bodied Medicaid beneficiaries to work. States would still have to apply for and be granted waivers in order to do so.

The move would make good on Centers for Medicare & Medicaid Services Administrator Seema Verma’s promise to “turn the page” on the Medicaid program, which includes not only encouraging beneficiaries to work, but also streamlining the waiver process and creating quality scorecards.

But not everyone agrees that Medicaid work requirements are a wise idea. Research has pointed out that most people eligible for Medicaid who can work are already working. Such a policy could also lead to worse outcomes and higher costs if individuals cycle in and out of employment—and thus Medicaid eligibility, Medicaid Health Plans of America CEO Jeff Myers told FierceHealthcare previously.

“That will obviously interrupt care management that the plans have built for chronic conditions that actually cost the state a lot of money,” he said.

In other Medicaid-related news:

Maine governor resists Medicaid expansion

Though Maine passed a ballot measure last fall to expand Medicaid eligibility, the state’s conservative governor isn’t giving up his fight against it.

Gov. Paul LePage—who vetoed Medicaid expansion measures five times during his tenure—argued that lawmakers should not raise taxes to pay for enacting the newly passed ballot measure, according to Kaiser Health News.

“If they do not fund it, it will not be implemented,” he said. His administration also estimated the price tag will be much higher than what the state legislature’s nonpartisan fiscal office has projected—and LePage said he will take legal action if they can’t resolve that disagreement.

Medicaid advocates, however, are pushing lawmakers to put the new law into effect as soon as possible.

Iowa’s move to privatize Medicaid saved less than expected

Iowa will save $47.1 million this year by having private companies manage its Medicaid program, according to a new report (PDF) from the state’s Department of Human Services.

However, former Gov. Terry Branstad, who ordered the move to managed care, originally estimated the state would save $232 million this year, the Associated Press reported.

The state’s new Medicaid director now believes his staff miscalculated that estimate, according to a spokeswoman for current Republican Gov. Kim Reynolds. But Reynolds continues to support the state’s privatization of Medicaid, she added.