Skip Navigation

PRESS RELEASE: Heartland Institute Experts React to Kentucky Medicaid Work Requirement

January 12, 2018

"The Trump administration should be highly commended for this action." - Tim Huelskamp

stethoscope and insurance docs

The state of Kentucky on Friday became the first state in the nation to impose work requirements on those who receive Medicaid benefits – just one day after the federal Centers for Medicare and Medicaid services issued guidance allowing it. Kentucky says requiring Medicaid recipients to work 80 a month – in either a job, job training, education, or community service – will reduce the number of residents of the Bluegrass State on Medicaid by 86,000 within five years and save the state more than $330 million.

The following statements from health care policy experts at The Heartland Institute – a free-market think tank – may be used for attribution. For more comments, refer to the contact information below. To book a Heartland guest on your program, please contact Media Specialist Billy Aouste at and 312/377-4000 or (cell) 847/445-7554.

“The Trump administration should be highly commended for this action.

“Millions of Americans receive health insurance from their employer, meaning they work for it. There’s no reason why those who receive health insurance from taxpayers via Medicaid shouldn’t work for it, too. Kentucky’s requirement that able-bodied adult Medicaid recipients work at least 80 hours a month – either by pursuing more education and job training, or even volunteer in the community – is a very low but important hurdle. The Heartland Institute will continue to work with other states and the Trump administration to submit and approve waivers from other states.”

Tim Huelskamp, Ph.D.
The Heartland Institute

Dr. Huelskamp represented Kansas’ 1st District in the House of Representatives from 2011 to 2017.

“The tipping point for Medicaid reform in the states is finally here. The approval of Kentucky’s well-crafted Medicaid waiver is the green light states across the country have been waiting for. The waiver’s approval signals that the Centers for Medicare and Medicaid Services and the Trump administration are truly open to the kind of systemic reforms that states need to transform their Medicaid programs and return them to the affordable safety nets they were intended to be.

“Work requirements are only one part of Kentucky’s waiver. It also provides for cost-sharing, giving Medicaid recipients more responsibility for their care and encouraging them to make better decisions with how they seek care. With Kentucky’s waiver as a model, states across the country should propose waivers of their own expanding on what Kentucky has done.  This is only the beginning.”

Matthew Glans
Senior Policy Analyst
The Heartland Institute

“Seema Verma’s decision to approve Kentucky’s Medicaid proposal represents a watershed moment for the 53-yearold program. For years, Medicaid has trapped millions of working-age adults in poverty, while devoting less resources to care for the truly needy.

“Thanks to Gov. Matt Bevin’s reforms, Medicaid recipients in Kentucky will be able to reenter the workforce and attain private health insurance that provides higher quality health coverage than Medicaid. Today’s announcement is welcome news for governors and legislators across the country who are interested in lifting struggling families out of poverty and strengthening America’s fraying safety net.”

Charles Katabi
State Government Relations Manager
The Heartland Institute

“Please note that in Kentucky, 70% of the Medicaid population is on a managed-care plan. The Medicaid money goes to the plan, not the patient or the provider of services--and is paid monthly whether the patient receives any care or not. Removing able-bodied, healthy people from Medicaid means that corporate monoliths will lose their government handout, which they might have spent on lavish salaries or offices. Medicaid recipients who need care likely get it in emergency rooms. Those terminated from the program will continue to get care if needed. The hospital will try to re-enroll the patient then. Adding a work requirement is highly unlikely to diminish actual care.”

Jane M. Orient, M.D.
Executive Director
Association of American Physicians and Surgeons

“Having received a federal waiver, Kentucky will now require able-bodied Medicaid enrollees to expend at least 80 hours a month either working or doing community work. This only makes sense. Able-bodied individuals need to be about finding ways to increase their income so that they are encouraged to find jobs that offer a health benefit, and then leave Medicaid. Let’s ask other states to follow Kentucky’s lead.”

Dave Racer
Policy Advisor, Health Care
The Heartland Institute

Article Tags
Health Care Entitlements
Tim Huelskamp is the president and CEO of The Heartland Institute. @CongHuelskamp
Matthew Glans joined the staff of The Heartland Institute in November 2007 as legislative specialist for insurance and finance. In 2012, Glans was named senior policy analyst. @HeartlandGR
Charlie Katebi is state government relations manager with the Heartland Institute
Jane M. Orient, M.D. is executive director of the Association of American Physicians and Surgeons and president of Doctors for Disaster Preparedness. @jorient
Dave is the President of DGRCommunications, Inc., providing research, writing, publishing, and communication services for a diverse group of individual and corporate clients, and is the founder and CEO of Alethos Press, a book publisher.