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CMS Approves Ohio Medicaid Work Requirement

April 29, 2019

Ohio has become the eighth state to receive federal approval to implement a work requirement for its expanded Medicaid program.

Ohio requested permission to alter federal eligibility rules under a Section 1115 waiver and received approval from the Centers for Medicare and Medicaid Services (CMS) on March 15.

The work rules will apply to any able-bodied adult covered under the state’s expanded Medicaid program and would not apply to caregivers, individuals aged 50 or older, those with a chronic medical condition, or those who qualify for the Supplemental Nutrition Assistance Program or the Able-Bodied Adults Without Dependents Program.

To remain eligible for the program, Medicaid recipients must show they are working at least 20 hours a week, looking for work, receiving education or training, or participating in community service.

It is unclear when Ohio will begin enforcing the new rule. Litigation has delayed Medicaid work requirements in Arkansas and Kentucky. A similar suit is pending in New Hampshire.

Indiana has a fully implemented work rule. Alabama, Mississippi, Oklahoma, South Dakota, Tennessee, Utah, and Virginia are waiting approval for their work rule waiver requests.

‘One Stop Shop’

“If you are struggling to get ahead, we want to make sure that you have access to health care coverage, but we do expect you to work in return for that coverage,” said Ohio Lt. Gov. Jon Husted in an interview with WSYX-TV.

“This was a controversial part of the Obamacare plan, and the legislature has resisted Medicaid expansion for a number of years,” Husted said. “[Former Gov.] John Kasich implemented it. What we sought was a waiver to that policy, so that we could add a work requirement.

“And also, upon signing up for this, we are going to give them the ability to sign up for job training or apply for a job. It will all be a one-stop shop,” Husted said.

Work Requirement Bonus

Ohio’s decision to request a work requirement is smart for the taxpayers and good for Medicaid enrollees, says Rea Hederman, vice president and executive director of The Buckeye Institute.

“Research has shown that Medicaid expansion can lead to enrollees working less, leaving the labor market entirely [in order] to maintain Medicaid benefits,” said Hederman. “Welfare reform has shown us that work requirements encourage people to find jobs. Ohio policymakers are aware of this research and want to ensure that Ohio’s system helps keep people connected to the workforce, which our research shows will help recipients gain valuable work experience and generate higher earnings and incomes.”

According to the 2018 report, Healthy and Working: Benefits of Work Requirements for Medicaid Recipients,a work requirement could increase lifetime earnings by close to $1 million for individuals who transition off of Medicaid, and lifetime earnings by more than $300,000 for those who remain on Medicaid for their entire working life.

“By keeping enrollees connected to the workforce, Medicaid work requirements will help people gain experience and learn new skills,” Hederman said.


Cory Compton (thecomptonjr@gmail.comwrites from Cheboygan, Michigan.