Arizona’s Medicaid work requirements approved

Arizona is the latest state to have approval for a Medicaid work requirement program—joining seven other states with approved programs.

Since the Trump administration began permitting states to apply for Medicaid waivers that would require a certain population of beneficiaries to report work or work-related activities to remain eligible for benefits, thousands have lost critical health insurance coverage in a handful of states with approved programs. Most of these programs kick beneficiaries off Medicaid if they fail to report work activities three months out of the year. The programs are approved through section 1115 demonstration waivers.

Under Arizona’s new program terms, beneficiaries subject to work requirements could lose healthcare coverage if they miss three months of reporting. In addition, Arizona will be the first state to exempt federally recognized Native American tribes from the program, which will start in 2020 and impact about 120,000 people. Beneficiaries who are 19 through 49 will be impacted, with some other exemptions, and required to report at least 80 hours per month of work-related activities.

Proponents of the work requirements, dubbed community engagement programs, argue they incentivize people to help themselves out of poverty, while others state they punish vulnerable people and can contribute to poverty if beneficiaries lose their coverage. In Arkansas––the first state to implement a work requirement program––nearly 17,000 residents lost their Medicaid benefits by the end of the year after work requirements were implemented in June.

“Medicaid demonstrations like this one empower states to provide health coverage to their citizens while allowing the states the flexibility to tailor their approach to their unique populations,” CMS Administrator Seema Verma said in a statement. “We have long stressed the importance of meaningful tribal consultation when states are contemplating program reforms, and I’m pleased with how this important process informed Arizona’s approach to amending its demonstration.”

The programs have been met with controversy, including a legal hiccup in Kentucky after a judge blocked the work requirements from going into effect in the state. Kentucky has since received approval for work requirements again, which will go into effect in April and impact roughly 95,000 people. The legal battle could have national implications if it arises again.