A researcher says the U.S. may be at the beginning of "a snowball of states" moving towards Medicaid work requirements.
The Trump administration on Monday approved Arkansas' plan to require thousands of people on its Medicaid expansion to work or volunteer, making Arkansas the third state allowed to impose such restrictions on coverage. Kentucky and Indiana were the first two states.
"It's a great day for the state of Arkansas and really for taxpayers everywhere," says Nic Horton, Arkansas native and research director at The Foundation for Government Accountability (FGA). "We've got a Medicaid expansion program that's been almost 50 percent over enrollment projections, significantly over budget – and I think what Governor [Asa] Hutchinson [R-Arkansas] and the legislature have done here is a really good thing to help people get out of the welfare trap, back into work, and into self-sufficiency – while also protecting taxpayers at the same time."
While not all of them are states that expanded Medicaid, eight other states have waivers for Medicaid work requirements pending; and at least nine other states are actively involved in conversations with Centers for Medicare and Medicaid Services (CMS) about work requirements. CMS administrator Seema Verma was in Little Rock Monday for the announcement with Governor Hutchinson.
"I think we're really still at the beginnings of a snowball of states going towards Medicaid work requirements," Horton continues. "By the end of this year, you're talking about a couple of dozen states probably that are going to have Medicaid work requirements approved and moving towards being implemented."
Democrats have argued that Medicaid work requirements present a barrier to coverage. Other stated concerns have been that people will be discouraged from signing up. Still, Horton says it will not harm the people Medicaid is meant for – the blind, the disabled, and low-income children, among other examples.
Instead, Horton says Medicaid work requirements would apply to able-bodied, mostly childless, working-age adults who need jobs. "We want those people working and contributing to the economy so that limited Medicaid resources are available for folks who truly need it," he concludes.