Latest news with #BenjaminSommers
Boston Globe
22-05-2025
- Health
- Boston Globe
Republicans pass strictest Medicaid work requirement they have ever put forward
The legislation, which President Trump supports, still needs to pass the Senate, where Republican members are supportive of work requirements but where a few have expressed reservations about large Medicaid cuts. Get Starting Point A guide through the most important stories of the morning, delivered Monday through Friday. Enter Email Sign Up Republican leadership has described the policy as combating 'waste, fraud, and abuse.' Trump has said no one will lose health insurance under the legislation. But experts say it would leave millions uninsured. Advertisement While House Republicans fought fiercely among themselves over other Medicaid cuts, including dialing back funding for the Obamacare expansion, they have universally embraced work requirements. The policy is popular with the public, too: Recent polling finds that 60 percent of Americans and even 47 percent of Democrats support the idea. But by designing the work requirement proposal to be so rigid, the change could be just as transformative to the program as other large cuts that Republicans rejected. The Congressional Budget Office estimates that this and other Medicaid changes in an earlier version of the bill would cause 7.6 million people to become uninsured. Most of the people expected to lose coverage would be eligible for the program but unable to prove it under the law's strict paperwork standard. Advertisement The CBO estimates that the work requirement would save the federal government $280 billion over six years, about triple what the nonpartisan budget office had estimated earlier Republican plans would cut. All of those savings, which would help pay for Trump's tax cuts, are expected to come from fewer people having Medicaid. 'What this is really about is producing budget savings,' said Benjamin Sommers, a professor of health policy at Harvard University who has studied Medicaid work requirements. 'This is not savings through improved efficiency, or more people going to work. It's savings by kicking people out of the program who are mostly eligible.' The current proposal would require childless adults without disabilities who want Medicaid coverage to prove that they had worked, volunteered, or attended school for 80 hours in the month before enrollment. But states could require that people work six months or even a year before becoming eligible for public benefits. Those who fail to meet the work requirement would also be blocked from receiving subsidies for private plans sold on the Obamacare marketplace, another new restriction in this version of the Republican plan. The legislation is unclear on how long the prohibition would last. The law includes a series of possible exceptions — such as having a substance abuse disorder or caring for a sick family member — but does not detail how people will qualify or how frequently they will need to do so to remain covered. States could lose Medicaid funding if they fail to stop covering people who do not document their eligibility. Advertisement Older versions of Medicaid work requirements were somewhat more flexible, although they still came under intense opposition from Democrats. The plan that congressional Republicans came up with in 2023, for example, allowed poor people to prove they were working after they signed up for Medicaid and exempted those older than 55. Those who support Medicaid work requirements say the policy is about more than money. Some, including House Speaker Mike Johnson, say the requirement will encourage more poor Americans to contribute to society. 'You return the dignity of work to young men who need to be out working instead of playing video games all day,' he told reporters last month. The budget office, however, has said that these policies do not increase employment. Others believe that asking people to make some effort in exchange for public benefits builds trust in the programs. 'It's reasonable to have a work requirement because it sends an important message,' said Kevin Corinth, a senior fellow at the American Enterprise Institute, a conservative think tank. 'If you're not going to comply, that suggests you don't value the insurance, and it's maybe not worth the government spending those extra dollars.' Corinth, who worked for Trump during his first administration, did concede that there could be health effects, pointing in particular to an academic study from earlier this month finding that Medicaid saves lives. The federal government already has work requirements as part of its food assistance and welfare systems. Those programs boost the incomes of poor Americans, potentially making it easier for them to get by while working less. Advertisement Opponents of Medicaid work requirements contend it's a fundamentally different program because it does not provide cash benefits to individuals. They also note that most Medicaid enrollees are already working, in school, or too sick to be employed, as several studies have found. While Johnson has highlighted young men as a group that a work requirement could 'get off the couch,' unemployed Medicaid enrollees are more likely to be older women. The legislation originally gave states four years to prepare, with work requirements beginning in 2029, just after the next presidential election. Johnson defended the delay on Fox News last week, saying that states needed time to 'retool their systems.' This article originally appeared in
Miami Herald
22-05-2025
- Health
- Miami Herald
New Medicaid Work Requirements ‘Impossible' for People To Navigate
Medicaid work requirements, under consideration as part of the House Republicans' budget to cut federal spending, are "impossible" to navigate for those using the program, experts said. Part of the budget mandates 80 hours of verified community engagement per month for able-bodied Medicaid recipients ages 19 to 65. However, experts warn that the work requirements not only will see millions pushed off the program but also could lead to many struggling to understand what the new requirements mean for their working situation and how to report their work. If you're unsure exactly what the new requirements could mean for you, you're not alone. "Previous studies of states that have tried work requirements show that people are frequently unaware or confused about what the requirements mean and how to navigate the rules," Dr. Benjamin Sommers, a professor of medicine at Harvard Medical School in Massachusetts, told Newsweek. Corroborating this, Julie Marie Donohue, a professor and chair in the department of health policy and management in the School of Public Health at the University of Pittsburgh, told Newsweek: "Evidence from states that have imposed work requirements shows people have difficulty navigating reporting systems, especially when there are monthly requirements. "Medicaid work requirements can be complex for individuals to understand and for states to implement." Even without work reporting requirements, Medicaid is a complex program to navigate and manage, as Medicaid beneficiaries face "a significant amount of administrative burden," Jamila Michener, a professor of government and public policy at Cornell University in New York, told Newsweek. "They have to regularly recertify their eligibility, complete substantial paperwork, navigate managed care plans, coordinate their care, and adhere to a wide range of other requirements," she said, adding that was without having to additionally report work requirements. While noting the degree and extent of burdens imposed by work reporting requirements will depend on how states design the administrative processes necessary to implement them, Michener said that "adding such requirements to the mix only makes things harder. "Even in the best-case scenario, such requirements will lead to people who are eligible being denied benefits simply because they cannot jump over bureaucratic hurdles." The Congressional Budget Office (CBO) predicted that millions of Americans would lose their Medicaid health coverage under the new policy to scale back the Affordable Care Act (ACA), but experts are concerned that many could also lose their coverage because of the legislation's complexity and administrative burden. "Most of the people who will likely lose coverage will still be eligible for the program and lose their Medicaid due to red tape," Sommers said. Published studies show that more than 90 percent of Medicaid beneficiaries are already working or have a good reason for not working, Sommers said, adding this might be having a disability, caring for a family member or being in school, to name a few. This means that many who fulfill the requirements already could be confronted with a heavy administrative burden to prove that they are eligible for Medicaid coverage. Difficulties with reporting work could become an issue for many for different reasons. If reporting will be done online, those who lack "consistent, reliable access to the internet will struggle to report their work," Michener said, while "people who lack adequate transportation to get to reporting agencies will struggle to report their work," if reporting has to be in person. Those employed in "temporary, seasonal, contract-based or other jobs with less predictable, regular hours may struggle to report their work accurately or to meet the required hours," she added. Even recipients who are exempt from the requirement, including caregivers of dependent children, people with disabilities, people who are pregnant, and others, may struggle to prove they are exempt or may not realize they are supposed to be exempt, Michener said. "People in between jobs, doing gig work, working part-time, or who are self-employed may not know how to accurately report their work and may not know whether they remain eligible given these less traditional work arrangements. "Work requirements are simply Medicaid cuts by another name. They serve little other purpose. There is little to know evidence that work requirements actually boost labor market participation." Discussing what specific parts of the legislation appear to mean for different Medicaid recipients with Newsweek, Sara Rosenbaum, a professor of Health Law and Policy and founding chair of the department of Health Policy at the Milken Institute School of Public Health at George Washington University in Washington, D.C., said that when it comes to the number of hours recipients are required to work, it is important to know the 80 hours a month is not an average. This means that a Medicaid recipient cannot complete the working requirements at 85 hours for one month and then hit 75 hours the next month, Rosenbaum said, as "no averaging" is allowed. While the working requirements could be work, school, training or a number of other things, a recipient must complete the 80 hours each month. Rosenbaum said that "every hour needs to be separately proved," adding that it was "impossible to ask people to piece together their lives this way." Having to report every hour worked could be particularly difficult for those who are self-employed, Rosenbaum said. "It is impossible for people who work on their own, do odd jobs, clean houses, do yard work, etc., unless the implementing rules allow oral estimation," she said, adding that she didn't think this would be likely. Those who lose their work or can no longer complete the 80-hour requirement would "be obligated to report a changed circumstance since this is a condition of eligibility," Rosenbaum said. Those in the process of getting work or looking for work are not exempt from the 80-hour requirement, she said, adding that those who are exempt must also prove their exemption every month. "The measure is designed to do one thing-remove working-age adults from Medicaid," she said. Related Articles Medicaid Changes Get New Timeline: Who's ImpactedDonald Trump's Spending Bill Makes Progress as Medicaid Faces CutsTrump's Proposed Bill Could Leave Millions of Medicaid Patients UninsuredIowa Passes Medicaid Work Requirement 2025 NEWSWEEK DIGITAL LLC.
Newsweek
22-05-2025
- Health
- Newsweek
New Medicaid Work Requirements 'Impossible' for People To Navigate
Based on facts, either observed and verified firsthand by the reporter, or reported and verified from knowledgeable sources. Newsweek AI is in beta. Translations may contain inaccuracies—please refer to the original content. Medicaid work requirements, under consideration as part of the House Republicans' budget to cut federal spending, are "impossible" to navigate for those using the program, experts said. Part of the budget mandates 80 hours of verified community engagement per month for able-bodied Medicaid recipients ages 19 to 65. However, experts warn that the work requirements not only will see millions pushed off the program but also could lead to many struggling to understand what the new requirements mean for their working situation and how to report their work. Confusing Legislation For Work Requirements If you're unsure exactly what the new requirements could mean for you, you're not alone. "Previous studies of states that have tried work requirements show that people are frequently unaware or confused about what the requirements mean and how to navigate the rules," Dr. Benjamin Sommers, a professor of medicine at Harvard Medical School in Massachusetts, told Newsweek. Corroborating this, Julie Marie Donohue, a professor and chair in the department of health policy and management in the School of Public Health at the University of Pittsburgh, told Newsweek: "Evidence from states that have imposed work requirements shows people have difficulty navigating reporting systems, especially when there are monthly requirements. "Medicaid work requirements can be complex for individuals to understand and for states to implement." New Medicaid Work Requirements "Impossible" for People to Navigate New Medicaid Work Requirements "Impossible" for People to Navigate Photo Illustration by Newsweek/Getty/Canva Even without work reporting requirements, Medicaid is a complex program to navigate and manage, as Medicaid beneficiaries face "a significant amount of administrative burden," Jamila Michener, a professor of government and public policy at Cornell University in New York, told Newsweek. "They have to regularly recertify their eligibility, complete substantial paperwork, navigate managed care plans, coordinate their care, and adhere to a wide range of other requirements," she said, adding that was without having to additionally report work requirements. While noting the degree and extent of burdens imposed by work reporting requirements will depend on how states design the administrative processes necessary to implement them, Michener said that "adding such requirements to the mix only makes things harder. "Even in the best-case scenario, such requirements will lead to people who are eligible being denied benefits simply because they cannot jump over bureaucratic hurdles." Implications Of The Legislation The Congressional Budget Office (CBO) predicted that millions of Americans would lose their Medicaid health coverage under the new policy to scale back the Affordable Care Act (ACA), but experts are concerned that many could also lose their coverage because of the legislation's complexity and administrative burden. "Most of the people who will likely lose coverage will still be eligible for the program and lose their Medicaid due to red tape," Sommers said. Published studies show that more than 90 percent of Medicaid beneficiaries are already working or have a good reason for not working, Sommers said, adding this might be having a disability, caring for a family member or being in school, to name a few. This means that many who fulfill the requirements already could be confronted with a heavy administrative burden to prove that they are eligible for Medicaid coverage. Difficulties with reporting work could become an issue for many for different reasons. If reporting will be done online, those who lack "consistent, reliable access to the internet will struggle to report their work," Michener said, while "people who lack adequate transportation to get to reporting agencies will struggle to report their work," if reporting has to be in person. Those employed in "temporary, seasonal, contract-based or other jobs with less predictable, regular hours may struggle to report their work accurately or to meet the required hours," she added. Even recipients who are exempt from the requirement, including caregivers of dependent children, people with disabilities, people who are pregnant, and others, may struggle to prove they are exempt or may not realize they are supposed to be exempt, Michener said. "People in between jobs, doing gig work, working part-time, or who are self-employed may not know how to accurately report their work and may not know whether they remain eligible given these less traditional work arrangements. "Work requirements are simply Medicaid cuts by another name. They serve little other purpose. There is little to know evidence that work requirements actually boost labor market participation." What Medicaid Requirements Mean For You Discussing what specific parts of the legislation appear to mean for different Medicaid recipients with Newsweek, Sara Rosenbaum, a professor of Health Law and Policy and founding chair of the department of Health Policy at the Milken Institute School of Public Health at George Washington University in Washington, D.C., said that when it comes to the number of hours recipients are required to work, it is important to know the 80 hours a month is not an average. This means that a Medicaid recipient cannot complete the working requirements at 85 hours for one month and then hit 75 hours the next month, Rosenbaum said, as "no averaging" is allowed. While the working requirements could be work, school, training or a number of other things, a recipient must complete the 80 hours each month. Rosenbaum said that "every hour needs to be separately proved," adding that it was "impossible to ask people to piece together their lives this way." Having to report every hour worked could be particularly difficult for those who are self-employed, Rosenbaum said. "It is impossible for people who work on their own, do odd jobs, clean houses, do yard work, etc., unless the implementing rules allow oral estimation," she said, adding that she didn't think this would be likely. Those who lose their work or can no longer complete the 80-hour requirement would "be obligated to report a changed circumstance since this is a condition of eligibility," Rosenbaum said. Those in the process of getting work or looking for work are not exempt from the 80-hour requirement, she said, adding that those who are exempt must also prove their exemption every month. "The measure is designed to do one thing—remove working-age adults from Medicaid," she said.
Yahoo
23-04-2025
- Health
- Yahoo
Cutting federal Medicaid expansion funding could lead to 30k additional deaths: Analysis
An attempt by Republican lawmakers to roll back the federal government's share of Medicaid expansion could result in tens of thousands of additional deaths, according to an analysis by a liberal think tank. The analysis by the Centers for American Progress (CAP), shared first with The Hill, found that about 34,200 more people would die annually if the federal government reduced its current 90 percent match for the expansion costs and states responded by dropping their Medicaid expansions. Twelve states currently have 'trigger' laws in place that would automatically end expansion or require changes if the federal match rate were to drop. The CAP analysis was based on a 2017 study of New York, Arizona, and Maine by health economist Benjamin Sommers of Harvard University's T. H. Chan School of Public Health. Sommers estimated that one additional life was saved annually for every 239 to 316 adults who gained insurance because of Medicaid expansion. States that have implemented ObamaCare's Medicaid expansion currently receive a 90 percent federal match rate for adults covered through the expansion. Congressional Republicans are looking at rolling that back as part of their reconciliation plan to pay for an extension of President Trump's tax cuts. No policy has been agreed to, but House Republicans have tasked themselves with finding $880 billion in cuts from the Energy and Commerce Committee, which has jurisdiction over Medicaid. The committee is eyeing a markup of its portion of the reconciliation legislation on May 7. 'The federal government is paying 90 percent of the Medicaid expansion. What we have talked about is moving that 90 percent level of the expansion back toward the more traditional level,' Rep. Austin Scott (R-Ga.) said in an interview Monday on Fox Business. 'Nobody would be kicked off Medicaid as long as governors decided they wanted to continue to fund the program.' Eliminating the enhanced federal match for the Medicaid expansion population would dramatically reduce federal spending, but it would also shift those costs to the states, forcing governors to make difficult decisions. Some Republicans, including President Trump, have balked at Medicaid benefit cuts. But House GOP leaders argue ObamaCare allowed states to expand Medicaid far beyond the truly needy, and the federal government should not be subsidizing that coverage. 'When you have people on the program that are draining the resources, it takes it away from the people that are actually needing it the most and are intended to receive it,' Speaker Mike Johnson (R-La.) said on Fox News last week. 'You're talking about young, single mothers, down on their fortunes at a moment—the people with real disabilities, the elderly,' he continued.' And we've got to protect and preserve that program. So we're going to preserve the integrity of it.' Earlier this month, 12 vulnerable and moderate Republicans said they would not back the reconciliation plan over concerns about cuts to Medicaid, but did not indicate whether they would oppose a federal match rollback. Copyright 2025 Nexstar Media, Inc. All rights reserved. This material may not be published, broadcast, rewritten, or redistributed.
The Hill
23-04-2025
- Health
- The Hill
Cutting federal Medicaid expansion funding could lead to 30k additional deaths: Analysis
An attempt by Republican lawmakers to roll back the federal government's share of Medicaid expansion could result in tens of thousands of additional deaths, according to an analysis by a liberal think tank. The analysis by the Centers for American Progress (CAP), shared first with The Hill, found that about 34,200 more people would die annually if the federal government reduced its current 90 percent match for the expansion costs and states responded by dropping their Medicaid expansions. Twelve states currently have 'trigger' laws in place that would automatically end expansion or require changes if the federal match rate were to drop. The CAP analysis was based on a 2017 study of New York, Arizona, and Maine by health economist Benjamin Sommers of Harvard University's T. H. Chan School of Public Health. Sommers estimated that one additional life was saved annually for every 239 to 316 adults who gained insurance because of Medicaid expansion. States that have implemented ObamaCare's Medicaid expansion currently receive a 90 percent federal match rate for adults covered through the expansion. Congressional Republicans are looking at rolling that back as part of their reconciliation plan to pay for an extension of President Trump's tax cuts. No policy has been agreed to, but House Republicans have tasked themselves with finding $880 billion in cuts from the Energy and Commerce Committee, which has jurisdiction over Medicaid. The committee is eyeing a markup of its portion of the reconciliation legislation on May 7. 'The federal government is paying 90 percent of the Medicaid expansion. What we have talked about is moving that 90 percent level of the expansion back toward the more traditional level,' Rep. Austin Scott (R-Ga.) said in an interview Monday on Fox Business. 'Nobody would be kicked off Medicaid as long as governors decided they wanted to continue to fund the program.' Eliminating the enhanced federal match for the Medicaid expansion population would dramatically reduce federal spending, but it would also shift those costs to the states, forcing governors to make difficult decisions. Some Republicans, including President Trump, have balked at Medicaid benefit cuts. But House GOP leaders argue ObamaCare allowed states to expand Medicaid far beyond the truly needy, and the federal government should not be subsidizing that coverage. 'When you have people on the program that are draining the resources, it takes it away from the people that are actually needing it the most and are intended to receive it,' Speaker Mike Johnson (R-La.) said on Fox News last week. 'You're talking about young, single mothers, down on their fortunes at a moment—the people with real disabilities, the elderly,' he continued.' And we've got to protect and preserve that program. So we're going to preserve the integrity of it.' Earlier this month, 12 vulnerable and moderate Republicans said they would not back the reconciliation plan over concerns about cuts to Medicaid, but did not indicate whether they would oppose a federal match rollback.
