On February 2, the Department of Health and Human Services (HHS) announced that it approved a waiver request by the state of Indiana to include work requirements in its Healthy Indiana Plan (HIP). This comes on the heels of approved changes to Kentucky’s Medicaid program, which also instituted work requirements.

Indiana and Kentucky are the first states to receive such approval since HHS Administrator Seema Verma signaled last November that state Medicaid programs would be given more flexibility to make reform.

HHS’s new approach, announced January 11, is “designed to assist states in their efforts to improve Medicaid enrollee health and well-being through incentivizing work and community engagement among non-elderly, non-pregnant adult Medicaid beneficiaries who are eligible for Medicaid on a basis other than a disability.”

States may apply for these waivers per section 1115 of the Social Security Act, which allows states to modify standard Medicaid requirements first via pilot programs, or demonstration projects, aimed at better serving Medicaid populations.

HHS is offering guidance to states interested in pursuing demonstration projects involving work requirements. As of January 11, HHS had received work requirement proposals from eight states in addition to Kentucky and Indiana.

Several advocacy groups have banded together to challenge Medicaid work requirements. They have filed suit in federal court to fight the Kentucky waiver and have said Indiana likely will be sued as well.

Robert B. Vogel, MD, JD
Retinal Ophthalmologist at Piedmont Eye Center, Lynchburg VA;
Attorney, Overbey Hawkins & Wright, PLLS, Lynchburg, VA;
Adjunct Professor, Humanities and Bioethics, Liberty University School of Medicine, Lynchburg, VA.