Indiana Became the Second State to Impose Work Requirements for Medicaid

The expansion of Indiana’s Medicaid model represents Health and Human Services Secretary Alex Azar’s first major policy decision as secretary. | Chris Kleponis/Getty Images
Chris Kleponis/Getty Images

Indiana became the second state to implement work requirements for Medicaid on Friday after the Trump administration approved their waiver.

The Donald Trump administration approved a waiver for Indiana to implement work requirements for the Healthy Indiana Plan (HIP), which provides Indians health insurance. The waiver will also include a tobacco surcharge and up to $240 million over three years for addiction treatment.

Indiana now requires HIP recipients in “community engagement” activities, which includes going to school, participating in a job training program, working, or volunteering.

Alex Azar, the new Health and Human Services (HHS) secretary, said in a statement, “Today’s announcement is one significant step in a long legacy of innovation in person-centered health care. Indiana’s vision and ours goes beyond the provision of quality health care. It recognizes that Medicaid can become a pathway out of poverty.”

Kentucky became the first state to implement work requirements for their state Medicaid program in January.

Kentucky Gov. Matt Bevin said on Friday:

With federal approval of our Medicaid waiver, Kentucky will lead the nation in constructive changes to Medicaid. This marks the first significant change to a federal entitlement program in more than 20 years. The result will be a transformational improvement in the overall health of our people and will provide a model for other states to follow.

The Kentucky government suggested that with the Medicaid work requirements, they will save roughly $2 billion federal and state dollars over the next five years.

The Medicaid work requirements would only apply to able-bodied working-age adults. Americans with disabilities, older Americans, children, and pregnant women would not have to comply with potential Medicaid work stipulations.

A Rassmussen poll in January found that 64 percent of Americans approve of work requirements for Medicaid.

Indiana Governor Eric Holcomb said in a statement on Friday:

A decade after it launched, Indiana’s HIP program has become the national model for a state-led, consumer-driven healthcare program that meets citizens’ needs, provides choices and improves lives. … This approval continues coverage for hundreds of thousands of Hoosiers and unlocks funding to expand resources to help people struggling with addiction.

CMS administrator Seema Verma, who worked with then-Indiana Gov. Mike Pence to reform the state’s Medicaid program, said, “This gives us a pathway to start approving waivers. This is about helping those individuals rise out of poverty.”


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