Utah is looking to re-implement work requirements for residents on Medicaid.
It’s one of 13 states with proposed or pending work requirement waivers for Medicaid. Public comment is currently open on the proposal until May 22.
Work requirements, also known as community engagement requirements, were originally put in place back in 2020 as part of Medicaid Expansion. The idea was to expand Medicaid to cover over 100,000 more people. On top of that, what was then known as the Utah Department of Health added the requirements because it said working helps stabilize people struggling with mental health conditions.
But the requirements were quickly suspended because of the pandemic. Now, a new waiver from the Utah Department of Health and Human Services would ask the federal government for Utah to be able to tack these requirements back onto its program.
If allowed, it would require expansion members to report completing “specified work-related activities” to maintain eligibility. Members would have to do the following for three consecutive months:
- Register for work through the state system.
- Complete an evaluation of employment training needs.
- Complete the job training modules as determined to be relevant to the member through the assessment of employment training needs.
- Apply for employment with at least 48 potential employers.
At a May 6 rally in Pioneer Park, a coalition of advocacy groups called Protect Medicaid Utah had several people share why they think the requirements would hurt those on Medicaid.
Disability Law Center policy analyst Stacy Stanford spoke at the gathering. After a car crash 15 years ago, she said she experienced a plethora of health issues, but struggled to get a diagnosis. Because doctors couldn’t figure out her illness, she didn’t have any paperwork, making her ineligible for Medicaid.
But Medicaid expansion changed that
“People no longer have to rely on a documented disability to be eligible for health insurance,” Stanford said. “This means disabled and chronically ill people are getting access to care without needing a mountain of paperwork.”
There are exemptions to the proposed rule. For example, if you are over 60, a member of a tribe, enrolled in part-time school or just aren’t able to physically or mentally complete the requirements, then you can still receive Medicaid without the work requirements.
Last February, the Kem C. Gardner Policy Institute reported that around 85,000 low-income adults relied on the expansion program to receive Medicaid. The Utah Department of Health and Human Services estimates that nearly 90% of people in the program would qualify for an exemption, and half of those who don’t would comply with the proposed requirements.
But that still means several thousand people could potentially lose health care coverage.
This could also affect people with health conditions that might prevent them from proving they qualify, said Evan Done, advocacy and public policy director at the Utah Support Advocates for Recovery Awareness.
“People with behavioral health conditions would have a really hard time doing basic things like submitting documentation for their work requirements, doing 48 job contacts in a period of time,” Done said. “It would be an onerous burden that would really kick people off [of Medicaid].”
Gayle Ruzicka, president of the conservative Eagle Forum, thinks the cuts will help balance Utah’s budget and supports what the state is advocating for.
“Anybody who is capable of working should work,” Ruzicka said. “Each of us have those different ways that we do that.”
And she said that people shouldn’t be afraid to scrutinize Medicaid to help Utahns save money.
“Everything needs to be looked at, studied [to] figure out ‘Where can we cut so that there's enough money for everyone and so we don't raise taxes?’” Ruzicka said.
Rachel Craig, the government affairs manager at the Association for Utah Community Health, understands why health care could be a target for cuts.
“It is such a large budget line item, it's easy to look at it and be like, ‘Oh, we can cut from here. We can cut from there,” Craig said.
But as an important safety net and lifeline for many, she said it’s that big on purpose.
