Jack Crowe, DCNF

Kentucky became the first state to implement work requirements for Medicaid eligibility Friday, one day after the Trump administration announced that it would begin granting waivers empowering states to exercise greater control of the administration of Medicaid dollars, in a reversal of long standing federal policy.

Kentucky Gov. Matt Bevin, who ran on a pledge to reverse the Medicaid expansion facilitated by his predecessor under Obamacare, praised the move as “the most transformational entitlement reform that has been seen in a quarter of a century,” during a Friday press conference.

“Why should a working-age person not be expected to do something in exchange for what they are provided?” Bevin asked during the press conference in Frankafort.

Under the new requirements, which will be phased in this July, able-bodied Medicaid recipients aged 19 to 64 will be required to work at least 20 hours per week. Recipients can also meet the requirement through volunteer work, caring for the elderly, job hunting or higher education. The plan, which requires the submission of documents proving compliance, also requires that recipients above the federal poverty line pay monthly premiums of up to $15.

There are roughly 350,000 able-bodied, working age Medicaid recipients in Kentucky, roughly half of whom already meeting the “community engagement” requirements, according to Bevin. Those who fail to meet the requirements will be granted a month to correct their failings before their benefits are eliminated.

The policy change is expected to result in 95,000 fewer Medicaid recipients after the five-year window granted by federal authorities, an aide to Bevin told The Washington Post.

“We are ready to show America how this can and will be done,” Bevin said Friday. “It will soon become the standard and the norm in the United States of America, and America will be better for it.”

The new requirements have drawn the ire of liberal lawmakers and activists, who argue they will drive down workforce participation because some number of poor people will be left untreated, preventing them from applying for and holding jobs.

“The administration has their chicken-and-egg story completely wrong — they say people need to work to get healthy,” Sheila Schuster, a longtime Kentucky health care advocate told The New York Times. “We all know that health is the foundation from which people go to school, go to work and keep their employment. So I’m afraid the administration is not only going backward, but doing it for completely the wrong reasons.”

Nine states have thus far joined Kentucky in submitting applications to introduce their own Medicaid requirements. The plans very by state but generally require some form of work, education or other form of community engagement for Medicaid eligibility.

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