Summit County is taking ‘wait and see’ approach to possible work requirements for Medicaid
January 12, 2018
The Trump administration has announced that it is prepared to allow states to impose work requirements on Medicaid recipients. The proposal, which has long been popular among fiscal conservatives, would require "able-bodied" Medicaid recipients to work, volunteer or do another approved activity to access their health benefits.
Seema Verma, administrator for the Centers for Medicare and Medicaid Services, promoted the policy change in conference calls with reporters as well as in a series of tweets.
"Activities that increase education and training help #Medicaid beneficiaries find sustainable employment, leverage hope, and achieve a better quality of life," she stated in one tweet.
In another, she deflected criticism that the policy would take away coverage from sick or disabled people, saying the work policy "only applies to able-bodied, working age adults and outlines protections for individuals determined to be medically frail or suffering from opioid addiction and other substance use disorders."
Ten states have requested the Trump administration to start testing such work requirements, but Colorado was not one of them. Furthermore, work requirements may not be as disruptive for Summit, as the county has very low unemployment to begin with. According to U.S. Bureau of Labor Statistics, Summit has a 2.1 percent unemployment rate as of November 2017. This means that nearly all residents work to live in the county and would not be susceptible to benefit cuts.
Tamara Drangstveit, executive director of the Family and Intercultural Resource Center, helps many lower-income Summit residents enroll in health insurance plans. When it comes to Medicaid work requirements, her position is nuanced. She supports the idea of allowing states to manage benefit requirements for Medicaid, as they are in the best position to understand the effects of policies on local communities. Thus, they may be in a better position to determine whether work requirements would encourage better health outcomes for Medicaid recipients.
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However, she also believes that constructing barriers to insurance might not be great for Summit, which has some of the highest insurance premiums in the nation.
"Anything that makes it harder for folks to get insurance is not a good thing for Summit County," she said. "There's definitely a correlation between the rate of uninsured and how expensive your insurance rates are. So the more people who are uninsured in Summit County, the more we all suffer."
Joanne Sprouse, director of the Division of Human Services for Summit County, said the county is not quite sure what to make of the guidelines until more details are released.
Sprouse said that the Medicaid expansion has benefited Summit County as "it has been very helpful in reducing the number of uninsured in Summit County." She added that limiting access to coverage can also make poverty situations worse.
"In many cases," she said, "health issues that aren't adequately treated can be a major obstacle in a person's ability to find a job or hold a job."
However, Sprouse said it is still unclear how Summit will be affected by the new guidelines. "At this point, we just don't know exactly what impact, if any, this will have in Summit County, so I don't want to go out on a limb by speculating," she said, adding that the county officials "have more questions than answers at this point."
Whether Colorado will be another state to attempt to enforce work requirements on Medicaid recipients may hinge on state elections in 2018 and 2020, with the possibility of a fiscally conservative state government more receptive such ideas taking power.