Health authorities are also preparing to withdraw the 2018 Trump administration letter, which first announced the labor requirements policy, and to rescind a separate letter earlier this year with the aim of making it more difficult for the next Biden government to quickly reverse the policy.
“CMS has serious concerns that now is not the appropriate time to test policies that risk a substantial loss of coverage or health benefits in the short term,” according to a draft health department implementation plan entitled “Medicaid Work. Requirement Rescission ”.
President Joe Biden, who targets other Trump health policies while looking to build Obamacare, has long signaled plans to unravel Medicaid’s job requirements. Democrats criticized the rules as illegal and aim to expel people from the program’s lists.
Trump Medicaid chief Seema Verma, who criticized Obamacare’s expansion of Medicaid to poor adults and drafted the requirements, argued that they would encourage healthy people to work and help keep state Medicaid programs financially sustainable.
Biden last month issued an executive order directing his health department to identify policies that fail to “protect and strengthen Medicaid”. But the draft implementation plan obtained by POLITICO points to the coronavirus pandemic as the central reason for reversing the work rules, arguing that the crisis “greatly increased the risk” that the policy would lead to “unintentional loss of coverage” .
“In addition, uncertainty about the persistent health consequences of COVID infections further exacerbates the damage from loss of coverage or lack of access to coverage for Medicaid beneficiaries,” said the plan.
The move also comes when the Supreme Court is scheduled to consider the validity of labor rules on March 29. Lower courts have so far blocked attempts to institute labor rules, which has led most states with the requirements to suspend their application. Biden’s plan to withdraw work rules could make the case of the Supreme Court debatable.
The Centers for Medicare and Medicaid Services have not responded to several requests for comment.
Ten GOP-led states that have asked the Trump administration for permission to work rules have been approved or “deemed approved,” according to the preliminary distribution plan. Several other states applied for permission to work rules, but were not approved before Trump stepped down.
The work rules were approved through Medicaid layoffs, which allow states to test ideas for health coverage. A new administration can usually undo exemptions that it believes do not support Medicaid’s goals, although states may protest the decision.
In the final weeks of the Trump administration, Verma asked states to sign contracts that would establish a lengthy process to eliminate labor requirements and other conservative changes in their Medicaid programs. Medicaid experts questioned whether these contracts are legally enforceable.
The health department in Friday is also planning to eliminate some references to the job requirements program and related documents from the Medicaid government website.
Instead, he will post a link to an HHS document entitled “Medicaid Demonstrations and Impacts on Health Coverage: A Review of the Evidence”. The document, among other topics, will address the “impact of job requirements on Medicaid’s commitment to Americans in need,” said the preliminary implementation plan.
Only one state, Arkansas, has fully implemented Medicaid’s working rules. About 18,000 people lost Medicaid coverage in 2018 during the few months that the requirements were in place, before a judge blocked them.