The new Secretary of Health and Human Services Alex Azar (the replacement for former HHS Sec. Tom Price who resigned over ethical questions) jumped on a plane out of Washington this past Friday. He headed off to Indiana to personally announce HHS had approved the state’s new work requirements for Medicaid recipients. Azar’s visit sent a clear signal about how much the Trump administration favors states enacting Medicaid work requirements-a change with potential to curtail or eliminate crucial healthcare benefits for many. (It might also signal Mike Pence’s influence and readiness to take over – if necessary.)
Azar’s messaging might lead some to wonder if such requirements might ever be considered here in Vermont – should our no-new-taxes, no-new -fees GOP Governor take a liking to the idea.
In Indiana, TPM.com explains: the Medicaid waiver — titled the Healthy Indiana Plan, or HIP for short — will allow the state to kick out enrollees who can’t prove they are working, studying, volunteering or applying for work at least 20 hours per week. People older than 60, pregnant women, primary caregivers and those deemed “medically frail,” among others, will be exempt.
“There is a robust body of academic evidence to show that work is a key component of well-being,” Azar said Friday in Indianapolis.
Supporters would love to find a solid correlation between work and improved health outcomes in order to promote work requirements for benefits. However TPM.com points out: the academic study HHS cited to argue that work requirements will make people healthier was conducted in England, where all citizens have access to universal health care whether or not they are employed.
Indiana now joins Kentucky in the pool of states to be granted the right to impose work requirements for some residents in order for them to receive Medicaid. A group of Kentucky residents are suing the federal government to halt the new rules, accusing the Trump administration’s actions are “threatening irreparable harm to the health and welfare of the poorest and most vulnerable in our country.” Eight other states are about to join the rush to impose work restrictions.
When questioned about the issue early in January according to VPR news, Vermont’s Secretary of Human Services Al Gobeille remarked that such restrictions would be a “high hurdle” and “tough to think about.” And not exactly reassuring to those who would oppose the changes, he added: “But I’m willing to take a look at it, if there’s any merit in it that would help people.”
Although Governor Scott reportedly has not reviewed the new Trump policy it may not be too farfetched that he might like the idea, after all he has proposed “slashing” part of Vermont’s Medicaid spending already. And quietly tucked away in his 2018 budget is a proposal to eliminate a $1.39 million disability assistance program designed to help disabled Vermonters hire home aides to assist with their daily needs, like bathing, getting dressed, or preparing food.
For now his administration hasn’t dismissed the idea – forcing people to work in order to receive Medicaid – as unacceptable philosophically. No, Scott’s administration is just worrying publicly that it might be a “high hurdle” (with a Democratic majority in both houses of the legislature) should they decide to go where Trump, Sec. Azar and almost a dozen mostly-GOP states want to lead them.