3 things to know about proposed Medicaid job conditions

Ohio is seeking approval from the federal government to require more people with Medicaid to work.

When Medicaid expanded, it added coverage for about 700,000 people in the state. Now, the Republican-majority Ohio General Assembly Ohio has required the state’s Department of Medicaid ask for approval to add job conditions for those covered through the expansion.

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Most Ohio residents enrolled through the expansion of Medicaid, the state-federal health insurance program for the poor, are already working or would be exempt because of things like their age, disability or care taking responsibilities.

The requests to add work requirements have sparked debate over whether the conditions are necessary to push people toward jobs and out of poverty, or whether the new rules will put unnecessary burdens on the poor and make health outcomes worse.

Here’s three things to know about the proposal.

1. This would be the first time that work requirements would be a condition to qualify for Medicaid.

Job requirements have never been allowed in the 52-year history of Medicaid. But the Trump administration opened the door to job conditions in January when the U.S. Centers for Medicare and Medicaid Services created criteria for states to create proposals for job conditions.

Other states are trying to create job requirements as well, targeting adults who are working age and able bodied. Kentucky and Indiana recently have had job requirements approved.

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2. This would affect about 36,000, though some say that’s a conservative estimate.

The majority of Ohioans on Medicaid should be exempted from the job conditions for reasons like being older than 50, having a disability, or participating in drug or alcohol treatment. The state estimated about 5 percent of Ohioans on Medicaid through the Affordable Care Act would risk losing their health insurance if they don’t either have a job for at least 20 hours per week, look for work, or attend school or job training.

But Loren Anthes, who researches Medicaid policy at The Center for Community Solutions in Cleveland, said the state’s estimate of 1 in 20 residents losing their Medicaid eligibility because of the new conditions might be a conservative prediction.

Looking to when work requirements were introduced for SNAP, Anthes said nearly 400,000 people lost eligibility compared to the initial 134,900 that the state estimated would lose their benefits. Even accounting for an improving economy, Anthes said the work requirements appear to have disqualified more people than the state predicted.

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3. The state is seeking public comment on the proposal until March 18.

Ohio Department of Medicaid will host public hearings on the proposal today at 9 a.m. at the Tangeman University Center in Cincinnati and 10 a.m. March 1 at the Ohio Department of Medicaid in Columbus. Public comment can also be submitted online until March 18.

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