Kentucky will now require many of its Medicaid recipients to work for their benefits, the first time ever a state has been permitted to impose such a provision.
The state announced Friday that it received federal approval to mandate certain Medicaid enrollees to hold jobs or participate in other employment activities for 80 hours a month. The decision came a day after the Centers for Medicare & Medicaid Services unveiled guidelines for states to file for work requirement waivers, an historic and controversial step that consumer advocates say will leave many more Americans uninsured.
Kentucky also can start charging its Medicaid enrollees monthly premiums ranging from $1 to $15, depending on income, and suspend some of those who fall behind in payments. The state will also provide recipients with a high-deductible health savings account, which it will fund, and offer incentives to purchase additional benefits, such as dental and vision coverage.
The work requirement, which will take effect in July, will apply to all able-bodied, working-age adults who are not pregnant, medically frail, full-time students or primary caregivers of dependents. About 350,000 Kentucky residents will be subject to this mandate, but about half of them already have jobs or are in other activities that would satisfy the requirement.
In addition to working, recipients can meet the requirement by volunteering, participating in job training or job searching and taking classes.
Kentucky officials say the new program will promote self-sufficiency, make residents healthier and put Medicaid on a more sustainable financial path. Initially, the waiver was projected to save $2.4 billion over five years.
“Kentucky HEALTH aims to improve lives and re-envision public assistance as a temporary safety net, not a long-term plan,” according to a state official.
About one-third of Kentuckians are on Medicaid, including nearly 500,000 low-income adults who joined the rolls through Medicaid expansion under Obamacare. The state also scores poorly on many health indicators, including cancer deaths, obesity, cardiovascular disease and substance abuse, and economic factors, such as poverty, median income and workforce participation rates.
Still, state officials say there…