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The policy shift by the Centers for Medicare & Medicaid Services instructs states on how to compel "able-bodied, working-age" Medicaid recipients to work in order to receive benefits.

CMS will support state efforts to align Medicaid work and community engagement requirements with SNAP or TANF requirements, where appropriate, as part of this demonstration opportunity.

Critics argue that the move is aimed at cutting the number of people receiving government-funded Medicaid. Currently, more than one-third of doctors won't see Medicaid patients, according to Verma. The work requirements will likely be challenged in court. She cited studies that show a correlation between good health and having a job. In states that decide to impose the new requirement, it is widely expected to shrink Medicaid rolls.

Federal law states what an American has to do to qualify for Medicaid, he said. Pregnant women, children, the elderly and the disabled are exempted from the requirements. That could mean counting time spent in drug treatment as a form of "community engagement". Many governors, including Republican ones, have defended the Medicaid program as being critical to addressing the substance abuse crisis. However, they will not be allowed to use federal Medicaid funding to finance these services.

The administration outlined the work-requirement plan in a letter to state Medicaid officials that indicates the administration's willingness to grant state requests to impose requirements on working-age, non-disabled Medicaid beneficiaries.

Many recipients already have jobs that don't provide health insurance and people are not legally required to hold a job to be on Medicaid.

Advocates for low-income people expressed dismay.

Asked whether Gov. Kim Reynolds might pursue a work requirement, a spokesperson, Brenna Smith, said Thursday that "the governor is reviewing and considering the guidelines that just came out today". "Whether we choose that flexibility or not in MA, you know, probably not". "This is about helping those individuals rise out of poverty".

Arizona, Arkansas, Indiana, Kansas, Kentucky, Maine, New Hampshire, North Carolina, Utah and Wisconsin already filed applications to add the work requirements, according to NPR.

"I am so determined to recover", said Ulibarri, who said getting back to work is her ultimate goal.

Medicaid covers about half of the babies born in this country, she said. "Believing that community engagement requirements do not support or promote the objectives of Medicaid is a tragic example of the soft bigotry of low expectations consistently espoused by the prior administration. They may have low-wage jobs They may have jobs where their employer doesn't offer health insurance". Notably, among adults with Medicaid coverage, almost 8 in 10 live in working families and a majority are working themselves.

Consumer advocacy groups are likely to consider legal action once CMS starts approving state waivers.

Thursday's policy change is the first to open the door to mandating work for recipients since Medicaid's introduction in 1965. He dismissed the agency's justification that unemployment makes people less healthy. Bullard said she has epilepsy and other medical conditions that make working long hours impossible. It has also helped people work: Studies of Medicaid expansion in OH and MI found that the majority of beneficiaries said that getting health coverage helped them look for work or remain employed.