Utah pauses Medicaid work requirements amid COVID-19

Dive Brief:

  • Utah on Thursday halted a program tying Medicaid eligibility to work hours, lowering barriers for low-income residents of the state to access the public health insurance as the novel coronavirus pandemic continues to spread across the U.S.
  • Utah was the only state with a running program tying coverage for its Medicaid expansion population to work or volunteering hours, under a Section 1115 waiver approved by CMS in December.
  • The program will be suspended immediately as a direct result of COVID-19, Kolbi Young, a spokesperson for Utah’s Division of Medicaid and Health Financing, told Healthcare Dive.

Dive Insight:

Those who contract COVID-19 can face severe complications, including lengthy hospital stays and use of a ventilator, leaving pricey medical bills in its wake.

The uninsured and low-income Americans will be hit the hardest. Utah’s decision Thursday comes as myriad businesses are shuttering their doors, resulting in a skyrocketing unemployment — and the loss of employer-sponsored health insurance, leaving Americans few options.

Utah, which reported its first confirmed COVID-19-related death March 22, expanded Medicaid under the Affordable Care Act late last year to adults with incomes up to 138% of the federal poverty level. The expansion made some 120,000 adults eligible for Medicaid starting Jan. 1, but included a work requirement provision requiring them to complete an online job assessment, online training programs and 48 job searches within the first three months of enrollment in the program in order to qualify.

The Trump administration has approved the controversial work requirements in 10 states, though judges have voided the programs in four — Arkansas, Kentucky, Michigan and New Hampshire — ruling they go against the stated objective of the Medicaid program.

Arizona, Indiana, Ohio, South Carolina, Utah and Wisconsin have received approval for their programs, which critics call a tactic to boot poor people off safety net insurance, but postponed their implementation.

The administration and large private health insurers have taken steps to expand COVID-19 diagnostics and medical care coverage to make it easier for Americans to be tested and treated for the disease.

HHS has rolled back regulations in Medicare and other public payer programs, including allowing traditional fee-for-service Medicare to cover virtual care visits, and CMS has issued sweeping Medicaid blanket waivers in a bid to grant states more flexibility in how they allocate funds to fight COVID-19, including paring back physician licensure requirements and allowing doctors to treat patients in overflow facilities.

As of Thursday, CMS had approved 41 state Medicaid waivers under the public health emergency President Donald Trump declared earlier this month, most recently in Nebraska, Alaska and Arkansas.

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