On Jan. 11, the Trump Administration issued a new guidance to states that will allow them for the first time in the program’s history to implement work requirements for able-bodied Medicaid recipients. Under the new policy issued by the Centers for Medicare and Medicaid Services (CMS), states can apply for waivers that would allow them to require able-bodied adults to obtain a job, enroll in job training or education programs, or volunteer as a condition to continue receiving Medicaid benefits.

On Jan. 12, Kentucky’s waiver for Medicaid work requirements was approved by CMS, making it the first time in history such reforms have been enacted.

Democrats have denounced the move as a heartless and reckless attempt to save money, but the evidence shows Medicaid in its current form is an unaffordable program that disincentivizes work, traps many people in poverty, and fails to provide adequate health care coverage for the millions of people who depend on the program.

Under the Medicaid expansion provisions in the Affordable Care Act (ACA), a law passed in 2010 without a single Republican vote, the federal government agreed to pay 100 percent of a state’s Medicaid costs for newly eligible enrollees through 2016, but only for those states that expand Medicaid to cover all non-elderly adults with incomes below 138 percent of the federal poverty level. Since 2016, the proportion of the costs covered by the federal government has gradually been reduced and will continue to do so until 2020, when the federal share will be 90 percent.

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