The Trump administration is all too willing to cut Medicaid benefits and the number of people receiving them.
They’ve signaled this for one thing by allowing states to end retroactive eligibility and to impose work requirements. Their overall message is that states need maximum flexibility because states almost always know best.
But remarkably, Kansas went too far even for this administration. This week, Kansas became the first and so far only state to be refused a Medicaid waiver under the current president. The federal government ruled that no, Kansas can’t kick people off Medicaid, the health care program for low-income Americans, just because they’ve been on it for three years.
The cruelty of the proposed lifetime cap was obvious from the start.
In Kansas, which has extremely strict income limits on its Medicaid program, most of those on the program are children, pregnant, elderly or disabled. After three years, the elderly and disabled are still going to be elderly or disabled.
So the cap would have touched only those parents of young children who to qualify already make no more than $8,000 a year for a family of three. Of the more than 400,000 Kansans on Medicaid, only about 12,000 fit into that category, as extremely low-income parents who are seen as able to work.
Seema Verma, administrator of the Centers for Medicare and Medicaid Services, said that as determined as the administration is to give states flexibility, “We’re also determined to make sure that the Medicaid program remains the safety net for those that need it most. To this end, we have determined we will not approve Kansas’ recent request to place a lifetime limit on Medicaid benefits for some beneficiaries.”
In a speech in Washington this week, Verma explained the decision. “We seek to create a pathway out of poverty,’’ she said, “but we also understand that people’s circumstances change, and we must ensure that our programs are sustainable and available to them when they need and qualify for them.”
There has been no ruling yet on another request on whether Kansas can add work requirements.
Unlike Kansas, the four states that have been approved to do that all expanded Medicaid under the Affordable Care Act.
If that work requirement is approved, some parents of young children in Kansans would likely lose their Medicaid coverage.
That’s because if they met the work requirement, they’d make too much to qualify for Medicaid, and if they didn’t meet the work requirement, they’d be kicked off of the rolls automatically.
Kansas Gov. Jeff Colyer said this week that he’s pleased the Trump administration is still mulling the proposal to impose a work requirement on those 12,000 Medicaid recipients who could work. “This important provision will help improve outcomes and ensure that Kansans are empowered to achieved self-sufficiency,” he said in a statement. It would do no such thing, but just the opposite.
But good job, Kansas, for using creativity and gumption to locate the outer limits of how far even this administration will go in penalizing those in poverty. No one can say you didn’t try.