In a historic first, President Trump issued guidelines Thursday that will allow states to require able-bodied Medicaid recipients to have work of some kind, CNN reports. While work activities have long been a staple of the welfare system, Medicaid has never had such a requirement before. "[C]ritics contend rules that could deny people coverage contradict its objectives," The Washington Post writes.
The first state expected to impose work requirements is Kentucky, where a waiver could be approved as soon as Friday. Kentucky's law would require Medicaid recipients to report income changes within 10 days, a policy that "boggles my mind," in the words of the Kentucky Equal Justice Center's Cara Stewart, who pointed to low-wage workers such as waitresses who have incomes that fluctuate. At least nine other states could soon follow with work requirements for Medicaid, the Post reports.
States are also apparently able to broadly choose their own definition of "able-bodied," "medically frail," and what qualifies as "work." The Trump administration says vaguely that work includes "community service, caregiving, education, job training, and substance use disorder treatment."
In anticipation of challenges in court, the Trump administration is arguing that people who are unemployed have "poorer general health" and that "productive work and community engagement may improve health outcomes," an assertion that has produced pushback by critics. "It's a little like saying that rain causes clouds," said the National Health Law Program's Leonardo Cuello. "It's more that people [with Medicaid] get care, which helps them be healthy and makes them able to work." Read more about the new policy at The Washington Post.