After a failed attempt to implement work requirements for Medicaid recipients, Idaho has resubmitted an amended work requirement waiver to the federal government. In order to change key parts of the Medicaid coverage, states must petition the U.S. Health and Human Services (HHS) for a waiver, which essentially allows a state to “waive” certain requirements of the federal law. Though controversial and subject to litigation, many states have petitioned HHS for permission to impose a certain number of hours of work per week as a condition of receiving coverage. Some exceptions exist, though they vary by state.
Under Idaho’s new proposed work requirements, enrollees would be required to complete 20 hours of work per week or lose coverage. Idaho’s next Medicaid enrollment period begins on November 1 with coverage beginning on January 1, 2020. It will likely take HHS months to process the waiver application; however, Idaho has said it will work to promptly notify impacted individuals if the waiver is granted after the enrollment period begins. However, these work requirements have been shown to exclude thousands of Medicaid beneficiaries from coverage after being implemented, as occurred in Arkansas over the past year when over 18,000 beneficiaries were disenrolled from Medicaid. Medicaid work requirements have also been challenged in court for failing to advance the purpose of the Medicaid program, including Arkansas, Kentucky, New Hampshire, and most recently, Indiana. Results of the cases in Arkansas, Kentucky, and New Hampshire are pending on appeal and the work requirements in those states have been halted until the cases are resolved.
Idaho’s Medicaid work waiver is not the only major health care reform underway in Idaho. Idaho recently voted to expand Medicaid, which is expected to increase coverage by 90,000 people and increase costs to the state by $4 million. Idaho also has four additional waivers under consideration, including a pending waiver that would expand coverage to outpatient behavioral health services for substance use disorders.
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