Category Archives: Medicaid

State Of Indiana Adds Work Requirement For Medicaid Recipients

On Friday, the state of Indiana was granted the approval of the federal government to now require adult recipients of Medicaid in the state by way of the Affordable Care Act to be required to work. Indiana is the second state in the country to add this stipulation.

Individuals participating in Medicaid that fail to submit paperwork demonstrating continued eligibility for the program in a timely manner will lose benefits and not be able to reapply for three months.

More than 91,000 Medicaid enrollees in the state have had their benefits terminated for failing to complete the process for redetermination of eligibility requirements since November of 2015. To remain eligible for the process applicants must provide family size and proof of income in addition to other information in order to determine whether or not they still qualify for Medicaid coverage.

Before the implementation of these latest rules, applicants could reapply anytime for benefits. Officials for the state report that approximately one-half of the Medicaid participants that fail to complete the re-eligibility process are in fact still eligible for the program.

This new cause for Medicaid lockouts is an additional one the state had in place already in response to individuals that did not pay monthly premiums while having an income of more than $12,200 for a single individual. Lockouts for these individuals are triggered upon failure to pay premiums for two consecutive months. Data provided by the state of Indiana showed that in the first two years of this experiment 10,000 Medicaid recipients had their benefits terminated.

25,000 Dropped From Medicaid in Indiana

When the Obama Administration rolled out the Affordable Care Act, part of the program was for states to expand Medicaid coverage for those who made up to 138 percent of the poverty level. In exchange for states doing this, the federal government would pick up the vast majority of the state’s additional Medicaid costs.

 

Many states did expand Medicaid, yet several did not and have not. One state that did expand Medicaid coverage was Indiana. Indiana did make some requirements on new Medicaid recipients. They were required to pay a small premium for the coverage. If the premium was not paid, they would be removed from the Medicaid rolls. Those who didn’t not pay for two consecutive months were locked out of the Medicaid system for a period of six months.

 

Since Indiana’s Medicaid expansion law has been in effect, 25,000 people have been dropped from the Medicaid program due to a failure to pay their premiums. Those who are under the poverty level don’t have their health coverage removed, but the Medicaid coverage for dental care and vision care are dropped.

 

Now, Indiana wants to place further restrictions on Medicaid recipients. The state wants to require all able-bodied Medicaid recipients to work or volunteer for at least 20 hours each week. Those who fail to meet these requirements will be dropped from Medicaid.

 

Anti-poverty advocates are upset about the existing and proposed rules. They feel that dropping someone from coverage will only lead to more emergency room use. They also feel that those dropped from coverage may experience poorer health as a result of loss of care