Fact Sheet
March 2018

Work Requirements in Medicaid Waivers: These Aren’t About Work

CMS has approved work requirements (sometimes spun as “community engagement” requirements) in three states: Arkansas, Kentucky, and Indiana. Eight additional states have similar requests pending, and CMS appears likely to approve those requests, as well. Litigation challenging the authority of the executive branch to approve work requirements—rules that are contained nowhere in Medicaid law—have also begun.

View our 50-state map to see Medicaid waiver activity in the states.

Fact Sheet
March 2018

What CMS Did and Didn’t Approve in Arkansas’ Waiver—Both Tell Us A Lot

On March 5, 2018, CMS approved Arkansas’ request to add a work requirement to its Medicaid program.  Equally important, it did not approve the state’s request to roll back Medicaid eligibility to a partial Medicaid expansion. Both tell us a lot about what’s behind CMS’s approach to Medicaid waivers, and what states can expect to have, and not have, approved. View factsheet here.


December 5, 2017

Drug Testing in Medicaid Is Illegal and Hurts the People Who Need Help Most

Recently, the state of Wisconsin submitted an application to the federal government seeking Medicaid waiver authority to make drug testing a condition of eligibility for the state’s adult Medicaid program--BadgerCare. This request breaks dangerous new ground; drug testing has never been allowed as part of the application process in the Medicaid program. That’s because it is illegal, it will make it harder for everyone applying for Medicaid, and it will hurt rather than help those with substance use disorders.

September 15, 2016

CMS Rejects Ohio's Request for Harsh Policies in Its Medicaid Program

Erica Turret

Villers Fellow
Last week, CMS rejected Ohio’s request to make significant changes to its Medicaid program. 

With this decision, CMS is making it clear that policies that make it harder for the lowest-income people in the program to get health care are inconsistent with the goals of Medicaid. The decision also defined some boundaries regarding what is and is not appropriate for approval through the Medicaid waiver process.

September 8, 2016

Medicaid Expansion Improves People’s Financial Stability

Nygel Williams

Villers Fellow

Last month, Kentucky asked the federal government for approval to make significant and troubling changes to its highly successful Medicaid expansion program. To justify its request, the state asserted that these changes would help “break the cycle of poverty.” However, the results would likely be the opposite.

The fact is, by providing health insurance and helping people in the program avoid medical debt, Medicaid coverage can actually improve the financial health of its enrollees. Two recent reports, one in April and one in June, offer new evidence supporting that link.  

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