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What Are States Proposing for Work Requirements in Medicaid?

With the approval of Kentucky’s Medicaid expansion waiver, the Centers for Medicare and Medicaid Services (CMS) has for the first time granted a state permission to make Medicaid eligibility conditional on meeting a work requirement. Nine other states have waivers pending at CMS that would impose work requirements, including Arizona,…

Medicaid and Work Requirements: New Guidance, State Waiver Details and Key Issues

On January 11, 2018, the Centers for Medicare and Medicaid Services (CMS) issued a State Medicaid Director Letter providing new guidance for Section 1115 waiver proposals that would impose work requirements (referred to as community engagement) in Medicaid as a condition of eligibility. This issue brief provides an overview of this CMS guidance and summarizes states with work requirement provisions/requests as part of pending and approved Section 1115 Medicaid waivers.

New KFF Resource Tracks Developments in States’ Section 1115 Medicaid Waivers

A new resource from the Kaiser Family Foundation enables users to keep abreast of Section 1115 Medicaid waivers that are pending or have been approved by the Centers for Medicare and Medicaid Services. KFF’s Medicaid waiver tracker includes interactive maps that allow users to view states’ approved and pending waivers…

Understanding the Intersection of Medicaid and Work

Recent state requests for waivers of federal Medicaid law seek to make Medicaid eligibility contingent on work, and the Trump Administration has indicated a willingness to approve such waivers. This issue brief provides data on the work status of the nearly 25 million non-elderly adults without SSI enrolled in Medicaid to understand the potential implications of work requirement proposals in Medicaid. It shows that the majority of adults in this group are already working, and those who are not report major impediments to their ability to work such as illness or care-giving responsibilities.

Key Themes in Medicaid Section 1115 Behavioral Health Waivers

State interest in Medicaid Section 1115 behavioral health waivers, including mental health and substance use disorders, remains high. As of November, 2017, there are 15 approved and 11 pending behavioral health waivers in 22 states. This issue brief describes recent waiver activity in four areas: using Medicaid funds to pay for substance use and/or mental health services in “institutions for mental disease” (IMDs), expanding community-based behavioral health benefits, expanding Medicaid eligibility to cover additional people with behavioral health needs, and financing delivery system reforms.

How Medicaid Section 1115 Waivers Are Evolving: Early Insights About What to Watch

While efforts to pass major federal legislation to repeal and replace the Affordable Care Act (ACA) and restructure and reduce federal Medicaid financing may be on hold temporarily, the focus of the Centers for Medicare and Medicaid Services (CMS) and states is expected to turn to achieving significant Medicaid program changes through Section 1115 demonstration waivers. This issue brief presents three questions to help analyze the evolution of federal waiver policy as new waiver proposals and decisions emerge.

Mapping Medicaid Delivery System and Payment Reform

This interactive provides state-by-state data on Medicaid delivery system and payment reform initiatives. Users can track state Medicaid managed care, patient-centered medical home (PCMH), Health Home, Accountable Care Organization (ACO), and Delivery System Reform Incentive Payment (DSRIP) waiver activity.

Medicaid Enrollees and Work Requirements: Lessons From the TANF Experience

This issue brief considers the implications of conditioning Medicaid eligibility on satisfying a work requirement, drawing on state experience with TANF enrollees subject to a work requirement over the past two decades and data about work and the role of health coverage among Medicaid enrollees today.

Proposed Changes to Medicaid Expansion in Kentucky

On June 22, 2016, Governor Bevin released his proposed Section 1115 demonstration waiver application called Kentucky HEALTH (Helping to Engage and Achieve Long Term Health) as an alternative to the current Medicaid expansion which is being implemented through a state plan amendment according to the terms in the ACA. On July 3, 2017, Kentucky submitted an amendment, proposing several changes, to its pending waiver application to the new Administration. This fact sheet summarizes the proposed changes to the current Medicaid expansion in Kentucky.

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Filling the need for trusted information on national health issues, the Kaiser Family Foundation is a nonprofit organization based in Menlo Park, California.