The relationship between employment and access to health care is a hallmark feature of the United States’ health care
system. While this was not the case with Medicaid, the government-sponsored health insurance program for those living in poverty, the Centers for Medicare and Medicaid Services (CMS) announced earlier this year that states could apply for Section 1115 demonstration waivers that include a work requirement component.

Pennsylvania’s General Assembly is currently considering legislation that would allow the state to seek a 1115 waiver with not only employment and job search requirements, but also restrictions on benefits considered non-essential, such as hearing aids, patient education, and dental care, which can help manage chronic conditions as well as prevent others.

Work requirements would apply to Medicaid-eligible individuals who are not pregnant, do not have a disability, and are not elderly. While Pennsylvania Governor Tom Wolf does not necessarily support the idea of work requirements, the legislation may sneak through as part of a larger budget bill. Further, it is possible that Pennsylvania’s 1115 application will get approved by CMS, as many aspects of former governor Tom Corbett’s 1115 proposal were approved, although plans were scrapped once he lost the election in 2015. Corbett’s proposed application was quite stringent, with 20 hour-a-week work requirements, mandatory completion of 12 job training activities per month, and declining eligibility for noncompliance.

As more states apply for 1115 waivers including work requirements, legislatures and advocates need to consider what purpose Medicaid serves and why a basic right such as healthcare is tied to employment.

Read the source article at nonprofitquarterly.org