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Trump Medicaid chief can't cite any proof her work requirement plan actually helps people

Medicaid head Seema Verma has pushed work requirements for Americans on Medicaid without proof it improve health outcomes — and despite evidence it’s harmful.

By Nick Vachon - October 25, 2019
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Seema Verma

Rep. Joe Kennedy III (D-MA) had a simple question for Seema Verma, administrator of the Centers for Medicare and Medicaid Services (CMS), during a House Energy and Commerce committee hearing Wednesday

Ma’am, can you point me to one study that says work requirements make people healthier?” Kennedy asked during the hearing, titled “Sabotage: The Trump Administration’s Attack on Health Care.”

Verma attempted to dodge the question, pointing to “many studies that talk about how employment has a positive impact on health outcomes.”

Kennedy wasn’t satisfied.

“You guys run health care programs in this country, I am certain you understand the difference between correlation and causation,”Kennedy countered, referring to CMS, a federal agency within the Department of Health and Human Services. “Healthier people might work, work doesn’t necessarily make people healthier. You are imposing policies on millions of people across this country. Can you show me one study that says that is a good policy?”

Again, Verma dodged the question. “I’ve spoken to many people living on the Medicaid program living in poverty,” she said, “and none of those individuals want to stay where they are””

“I’ll take that as a no,” Kennedy said.

As Kennedy noted Wednesday, according to a study from the New England Journal of Medicine, more than 18,000 Medicaid recipients in Arkansas lost coverage after Verma’s agency approved the state’s work requirement policy. In New Hampshire, the number was nearly 17,000.

Numerous other studies have confirmed that work requirements are marginally effective at best and harmful at worst. They kick disabled and employed people off of government aid, fail to help unemployed people with significant barriers to employment find work, do not reduce poverty, and sometimes even push people deeper into economic crisis.

It isn’t just Americans in Arkansas and New Hampshire who are at risk of losing access to health care. Verma’s agency has approved work requirements in 10 states, and another 7 states are awaiting approval

The Government Accountability Office has found implementing work requirement policies to be staggeringly expensive. In Kentucky, Republican Gov. Matt Bevin was prepared to spend $270 million — half of which would be provided by the federal government — to track the state’s half a million Medicaid recipients and enforce work requirements. Arkansas would have spent $26 million, and New Hampshire was projected to spend around $6 million.

Federal judges struck down work requirements in Arkansas, New Hampshire, and Kentucky this year, but not before nearly 40,000 Americans lost their health care. In Maine, newly elected Democratic Gov. Janet Mills rejected work requirements that the previous Republican administration was planning to enact. Wisconsin and Michigan are the next states scheduled to introduce work requirements, in October and January, respectively.

The only lawsuit pending against work requirements is in Indiana, where roll out began on July 1. Notably, Indiana is where Verma profited off Medicaid reform before joining the Trump administration. 

In the early 2010s, when Mike Pence was governor, Verma’s consulting firm made millions of dollars overhauling the state’s Medicaid program, while at the same time receiving more than $1 million through a contract with a national company that processes state Medicaid claims. 

Former President George W. Bush’s chief ethics lawyer called it a “clear conflict of interest.”

Published with permission of The American Independent Foundation.


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