U.S. allows Utah to expand Medicaid with work requirement

SALT LAKE CITY (AP) — The Trump administration said Monday it will allow Medicaid expansion with a work requirement in Utah, a decision that came despite courts taking a dim view of the requirement in other states.

Republican lawmakers contend that work requirements make people healthier and more financially stable, but critics say the mandate jeopardizes healthcare for the poor and adds another hurdle for people with childcare and other responsibilities.

The announcement means the state will have full Medicaid expansion under former President Barack Obama’s signature healthcare law, covering a total of up to 120,000 adults starting Jan. 1.

Though Utah voters passed Medicaid expansion more than a year ago, conservative lawmakers have delayed its full implementation, saying it was too expensive. Health care advocates said they were glad more people will be eligible but wary about the work requirements they say could cause 7,500 people to lose coverage.

“The work reporting requirements are unnecessary and do nothing to promote health,” said Matt Slonaker, executive firector at Utah Health Policy Project.

The Trump administration has generally taken a favorable view toward work requirements and allowed South Carolina to impose them earlier this month. Nearly 20 states have asked to implement them, though a number have backed away amid court challenges.

A federal judge blocked the requirements in Arkansas and Kentucky in March, finding the measures undermined the program’s mission of providing healthcare for the needy.

Work requirement programs have also been suspended or dropped in states such as Arizona, Indiana and New Hampshire.

In Utah, officials argue their “self-sufficiency” requirement is different because it’s based on efforts to look for work rather than work a certain number of hours, said Nate Checketts, deputy director at the Utah Department of Health.

It also includes exceptions for many people, including those who are 60 or older, pregnant or caring for young children. As many as 80% of people who qualify for Medicaid could be exempt from the work requirement, Checketts said.

People who are subject to the requirement will need to complete an online job assessment, web-based training programs and 48 job searches within the first three months of being eligible for Medicaid.

Utah voters passed full Medicaid expansion last year, but the GOP-dominated Legislature said it would be too expensive and initially voted to scale back the number of people covered.

Republican Gov. Gary Herbert applauded the federal decision, saying Monday that it shows “states can craft viable, unique solutions to deliver critical health care services to their residents.”

Centers for Medicare and Medicaid Services called Utah’s plan an “innovative and sustainable” solution.

The U.S. government is also considering other requests by Utah officials, including premiums and surcharges for people over 100 percent of the federal poverty level and penalties for intentional program violations.