Biden Administration Moves to Stop Medicaid Work Requirements

MHE Publication, MHE March 2021, Volume 31, Issue 3

The Trump administration didn’t get very far with healthcare reform; the ACA was neither repealed nor replaced. But former CMS Administrator Seema Verma made a run at revamping Medicaid by using Section 1115 waivers to add working requirements. Now the Biden administration is taking steps to stop the requirements before they get started.

The Trump administration didn’t get very far with healthcare reform; the ACA was neither repealed nor replaced. But former CMS Administrator Seema Verma made a run at revamping Medicaid by using Section 1115 waivers to add working requirements. Now the Biden administration is taking steps to stop the requirements before they get started.

During the Trump administration, 19 states were at some stage of imposing Medicaid work requirements (eight waivers approved, seven pending, and four tied up in court).

Mid-February, the new administration sent out letters to two work-requirement states, Arkansas and New Hampshire, saying that CMS now has “serious concerns” about testing policies that might lead to loss of healthcare coverage amid the pandemic.

Verma made some eleventh hour changes to the waivers that will make it more difficult to undo them, but the Biden administration is working to dismantle those rules.

Changing Medicaid funding so states would receive block grants to run their programs was another change the Trump administration wanted to see. Tennessee has an 1115 waiver that would mean such funding for the state Medicaid’s program and, among other things, a closed formulary. But that waiver is now also in doubt.