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Katiri Zuluaga

Manager, State Initiatives

Ohio Becomes 9th State to Receive Approval for Medicaid Work Requirements

March 21, 2019 | Medicaid | Waivers/SPAs | Comments
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The Centers for Medicare and Medicaid Services (CMS) has approved Ohio’s Medicaid waiver to enact work requirements, even with legal challenges still pending in Kentucky and Arkansas for similar programs. Starting in 2021, Medicaid beneficiaries in Ohio not meeting certain exemptions will need to report 80 hours of “community engagement” per month to maintain coverage. Estimates indicate that approximately 18,000 people, about half of all eligible Medicaid beneficiaries, could lose coverage due to these new work requirements. The National Council for Behavioral Health remains strongly opposed to work requirements and other barriers that restrict access to needed behavioral health services.

Ohio’s Medicaid work requirements will impact all adult beneficiaries aged 19 to 50 years old who are not currently pregnant or caretakers, participating in drug or alcohol treatment, receiving unemployment or supplement security income (SSI) or in school at least half time. Individuals who lose coverage for failing to meet reporting requirements will be able to reapply for benefits immediately, differentiating Ohio from other states who generally require a waiting period prior to reenrollment.

An Update on the Medicaid Work Requirements Landscape

The Ohio approval came in the same week that the Trump Administration published new federal guidance on work requirements and defended both Kentucky and Arkansas’ work requirements in federal court. Kentucky’s Medicaid waiver including work requirements has been approved twice by CMS in the face of a legal challenge and Arkansas saw nearly 17,000 individuals lose Medicaid coverage in 2018 from failure to meet reporting requirements. The judge overseeing both cases is expected to make a decision next month on the fate of work requirements in Kentucky and Arkansas.

Ohio is the ninth state to receive CMS approval for Medicaid work requirements and seven states still have pending requests.