December 23, 2019 03:01 PM - Modern Healthcare
Associated Press
SALT LAKE CITY (AP) — The Trump administration said Monday it will allow Medicaid expansion with a work requirement in Utah, a decision that came despite courts taking a dim view of the requirement in other states.
Republican lawmakers contend that work requirements make people healthier and more financially stable, but critics say the mandate jeopardizes healthcare for the poor and adds another hurdle for people with childcare and other responsibilities.
The announcement means the state will have full Medicaid expansion under former President Barack Obama's signature healthcare law, covering up to 120,000 adults starting Jan. 1. Utah voters passed Medicaid expansion more than a year ago.
The Trump administration has generally taken a favorable view toward work requirements, and nearly 20 states have asked to implement them. A number of states, though, have backed away after a federal court decision in March blocked the requirements in Arkansas and Kentucky. The ruling found the measures undermined the program's mission of providing healthcare for the needy.
Work requirement programs have since been suspended or dropped in states such as Arizona, New Hampshire, Indiana and Maine.
In Utah, officials argue their "self-sufficiency" requirement is different because it's based on efforts to look for work rather than work a certain number of hours, said Nate Checketts, deputy director at the Utah Department of Health.
It also includes exceptions for many people, including those who are 60 or older, pregnant or caring for young children. As many as 80% of people who qualify for Medicaid could be exempt from the work requirement, Checketts said.
People who are subject to the requirement will need to complete an online job assessment, web-based training programs and 48 job searches within the first three months of being eligible for Medicaid.
Utah voters passed full Medicaid expansion last year, but the GOP-dominated Legislature said it would be too expensive and initially voted to scale back the number of people covered.
Republican Gov. Gary Herbert applauded the federal decision, saying Monday that it shows "states can craft viable, unique solutions to deliver critical health care services to their residents."
Centers for Medicare and Medicaid Services called Utah's plan an "innovative and sustainable" solution.
The U.S. government is also considering other requests by Utah officials, including premiums and surcharges for people over 100 percent of the federal poverty level and penalties for intentional program violations.