Leading Children’s Health, Medical and Advocacy Organizations Object to Work Requirements and Other Barriers to Medicaid Coverage

A broad and diverse group of children’s health, medical and advocacy organizations are speaking up against adding work requirements and other barriers to Medicaid coverage. Forty-four organizations sent a letter to HHS Secretary Alex Azar today expressing serious concerns about the agency’s proposed changes to Medicaid’s Section 1115 waiver policy, which could lead to thousands of children and families losing critical access to care.

March of Dimes, National Education Association, American Nurses Association, ZERO TO THREE, First Focus, Families USA, Community Catalyst, Family Voices, American Psychological Association, CLASP and American Osteopathic Association were among the groups joining the effort spear-headed by the American Academy of Pediatrics and Georgetown University CCF.

“Health care is a critical foundation for families and children struggling to thrive,” the letter states. “Cutting families off coverage will only make it more difficult for them to be productive, healthy and engaged members of their communities.”

The letter was in response to changes to long-standing waiver policy and waiver requests from states that would create more barriers to coverage including:

  • Coverage “lockouts” for failure to pay premiums on time or comply with additional reporting requirements
  • Work or “community engagement” requirements
  • Additional premiums or co-payments
  • Time limits on coverage and elimination of retroactive coverage

These additional bureaucratic hurdles would impact low-income parents, caretakers and youth aging out of foster care who are least able to overcome them. Cutting off Medicaid coverage for parents and caregivers will put their health and the health of children at risk. When a parent loses health coverage, the entire family is also put at greater financial risk.

The restrictions would impact some of the most vulnerable families in the United States. For example, the Mississippi waiver under consideration by CMS would impact those earning 27% of the Federal Poverty Level (approximately $468 a month for a family of three.) A Medicaid waiver proposal under consideration in Alabama would create more barriers to coverage for those earning 18% of FPL (about $313 a month for a family of three.)

Proponents who argue that creating more barriers to Medicaid coverage will help families rise out of poverty are out of touch with the reality these families face. It’s hard enough to raise a family on such a limited income without someone putting more roadblocks in the way.