Indiana becomes 2nd state approved for Medicaid work requirements

Work requirements have been added to Indiana’s Medicaid program, making it the second state to mandate participation in “community engagement” activities since CMS issued guidelines to states on including those provisions in Section 1115 Medicaid waivers.

Like Kentucky’s waiver, the Indiana plan will require “able-bodied” Medicaid beneficiaries to engage in activities like working, going to school, attending a job training program or volunteering as a condition of their coverage. CMS Administrator Seema Verma had consulted on a prior version of Indiana’s Medicaid program, the Healthy Indiana Plan.

“Today’s announcement is one significant step in a long legacy of innovation in person-centered health care,” said HHS Secretary Alex Azar, according to the Indianapolis Star. “Indiana’s vision and ours goes beyond the provision of quality health care. It recognizes that Medicaid can become a pathway out of poverty.”

While the waiver also includes changes like a tobacco surcharge for beneficiaries and $240 million in funding for addiction treatment, it’s the controversial work requirements grabbing most of the attention. A lawsuit has already been filed to block Kentucky’s waiver, arguing the required activities are beyond the authority of HHS and CMS, and Indiana groups are already concerned the real goal is to reduce Medicaid enrollment.

“Adding an extra layer of work requirements will be really pretty tough,” said Adam Mueller, advocacy director of Indiana Legal Services. “What we’re talking about is a significant bureaucratic apparatus to run this program and that’s going to lead to folks falling through the cracks and that’s one of our biggest concerns.”

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