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Biden Plans to Rescind Trump-Era Medicaid Work Requirements

The move has been lauded as a step toward reversing one of Trump’s most vicious attacks on the poor and vulnerable.

Then-Centers for Medicare and Medicaid Services Administrator Seema Verma listens as then-President Donald Trump speaks in the Brady Briefing Room at the White House on April 7, 2020, in Washington, D.C.

The Biden administration on Friday is expected to begin the process of rescinding a Trump policy allowing states to impose punitive work requirements on Medicaid recipients, a move celebrated as a crucial step toward reversing one of the former president’s most vicious attacks on the poor and vulnerable.

According to the Washington Post, which obtained a draft of the Biden administration’s plan, federal health officials on Friday “will withdraw their predecessors’ invitation to states to apply for approval to impose such work requirements and will notify 10 states granted permission that it is about to be retracted.”

The brainchild of Seema Verma, head of the Centers for Medicare and Medicaid Services under Trump, the work requirements initiative began in 2018 with guidance allowing states to apply for a waiver to significantly alter Medicaid eligibility requirements. Several Republican-led states quickly jumped at the offer; Arkansas, the first and only state to fully implement Medicaid work requirements, threw at least 18,000 people off the healthcare program over a period of several months in 2018.

While the destructive efforts of Arkansas and other states were largely stymied by federal court interventions, the Biden administration’s plan to roll back the Trump work requirements guidance was applauded as key progress toward definitively ending one of the former president’s most prominent efforts to strip healthcare from low-income people.

“We worked so very hard for this,” Matthew Cortland, an attorney and disability rights activist, said of the effort to defeat the work requirements. “We celebrate this win — this win that we made happen — even while mourning the loss of every person who relied on Medicaid and didn’t survive the calamity of Trump’s disastrous administration.”

Larry Levitt, executive vice president for health policy at the Kaiser Family Foundation, argued in a series of tweets late Thursday that “the Trump administration’s Medicaid work requirement policy was never really about work,” noting that “93% of Medicaid beneficiaries who are not on Medicare or SSI are already working, taking care of a family member, going to school, or not working due to illness.”

“Medicaid work requirements have roots in the ideology that healthcare under Medicaid should be considered welfare for the deserving poor rather than a right,” Levitt added.

In a last-ditch effort to preserve the work requirements policy during the final weeks of the Trump administration, Verma “asked states to sign contracts that would establish a lengthy process for unwinding work requirements and other conservative changes to their Medicaid programs,” Politico reported Thursday.

“Medicaid experts have questioned whether those contracts are legally enforceable,” the outlet noted.

The Biden administration’s plan — which points to the ongoing coronavirus pandemic as a major reason to end the Trump era guidance — will come over a month before the U.S. Supreme Court is set to hear a case on the legality of the Medicaid work requirements. According to the the Wall Street Journal, Biden health officials are “expected to move quickly to end work requirements in Medicaid… because doing so could moot” the Supreme Court case.

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