The Centers for Medicare and Medicaid Services (CMS) is now reviewing a waiver proposal from Alabama to establish work requirements for Medicaid beneficiaries. Previous work-requirement waiver applications have been submitted by or approved for states that had expanded their Medicaid programs to cover childless adults pursuant to the Affordable Care Act (ACA), and which proposed to impose the work requirements only on that population. Alabama, however, did not expand Medicaid and proposes to establish a work requirement for the “traditional” Medicaid population, including parents of young children. As explained in its waiver application, the state proposes to mirror its TANF JOBS Program, so will require able-bodied Medicaid beneficiaries to participate in 35 hours per week of employment-related activities, or 20 hours per week if they are a parent or caretaker relative of a child under age 6 years old. See Trump Administration to Review Alabama Work Requirements for Medicaid (The Hill, 9/21/18). Public comments on the Alabama waiver are due on October 21.

South Dakota has also submitted a waiver proposal to CMS to establish a requirement in two counties (comments due Sept. 26), and Virginia is developing one that is open for public comment at the state level until October 20.

More on state waivers:

  • Section 1115 Medicaid Demonstration Waivers: The Current Landscape of Approved and Pending Waivers (article; issue brief) (Kaiser Family Foundation issue brief, 9/20/18)
  • An Early Look at State Data for Medicaid Work Requirements in Arkansas (article; issue brief Kaiser Family Foundation, 9/13/18)

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