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CMS approves Medicaid work waiver for Wisconsin

Wisconsin becomes the fourth state to require Medicaid beneficiaries to work, get job training or volunteer as a condition of receiving the benefit.

Susan Morse, Senior Editor

The Centers for Medicare and Medicaid Services has approved the fourth state waiver for work or other requirements as a condition of receiving Medicaid benefits.

CMS Administrator Seema Verma signed Wisconsin's demonstration request for work requirements to its Medicaid program, BadgerCare.

Adults applying for Medicaid will be required to complete a health risk assessment. The information collected will be used by the state to identify health risks and reward beneficiaries for avoiding certain health risks. It will also be given to health plans to better address health needs.

WHY THIS MATTERS

The work requirement is controversial as opponents say it kicks beneficiaries off of Medicaid, such as in Arkansas where there are  now a reported 8,500 fewer beneficiaries.

THE TREND

The waiver demonstration in Wisconsin is for five years.

Wisconsin joins Indiana, Arkansas and New Hampshire in using the requirement as an incentive for job training and employment.

In Kentucky, which made a request for a waiver, CMS reopened the comment period after a lawsuit was filed.

A similar lawsuit has been filed in Arkansas.

The Medicaid and CHIP Payment and Access Commission, in its October 25 meeting, decided to advise Department of Health and Human Services Secretary Alex Azar to hold off on approving Medicaid work requirements, according to Bloomberg Law.

WHAT ELSE YOU NEED TO KNOW

In releasing the news on Wisconsin's waiver, Verma said the state has a 3 percent unemployment rate and employers, such as a parts manufacturer in Sheboygan, are looking for help.

Work requirement exemptions are given to those who have disabilities, are medically frail, serve as primary caregivers, or have a medical condition that prevents them from meeting the requirement.

In Wisconsin, the requirement applies only to non-exempt adults under the age of 50 without children. Those eligible will be required to participate at least 80 hours a month, or 20 hours a week, in employment, job training, volunteer community service or enrollment in a qualified work program. They can participate for a total of four years before being subject to a six-month period of non-eligibility, after which they will be free to re-enroll.

Wisconsin becomes the 17th state to be approved to use Medicaid funding to finance a continuum of care for combating substance use disorders, Verma said.

ON THE RECORD

"I recognize that there are people who disagree with this approach. Some believe that our sole purpose is to finance public benefits, even if that means lost opportunity and a life tethered to government dependence. Instead, what's needed are local solutions crafted by policy makers who are closer to the people they serve and the unique challenges their communities face," CMS Administrator Seema Verma said.

THEIR TAKE

"We will not retreat from this position," Verma said.

Twitter: @SusanJMorse
Email the writer: susan.morse@himssmedia.com