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Verma Outlines ‘Vision’ for Medicaid

By John Commins  
   November 07, 2017

CMS chief vows to 'turn the page on Medicaid' and grant states more leeway; pushes work requirements for 'able-bodied' adults; raps Obama Administration's 'soft bigotry of low expectations.'

Centers for Medicare & Medicaid Services Administrator Seema Verma on Tuesday lashed out at the "Washington knows best, one-size-fits all Medicaid policy" and said the Trump administration will push for more state control of their programs.

In her first major speech on Medicaid, delivered at a plenary session at the National Association of Medicaid Directors Fall Conference in Arlington, VA, Verma said the administration's "vision for the future of Medicaid is to reset the federal-state relationship, and restore the partnership, while at the same time modernizing the program to deliver better outcomes for the people we serve."

That flexibility for states is expected to include allowing work requirements for "able-bodied" Medicaid enrollees that were brought onto the program under the Affordable Care Act, a topic that Verma touched upon several times in her speech. 

"The thought that a program designed for our most vulnerable citizens should be used as a vehicle to serve working age, able-bodied adults does not make sense," she said, "but the prior administration fought state led reforms that would've allowed the Medicaid program to evolve to meet the needs of these new individuals, and they did this, even when increased coverage was at stake."

"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. Those days are over," she said. "Let me be clear to everyone in this room, we will approve proposals that promote community engagement activities."

Verma referred to "able-bodied" or "non-disabled" adults, individuals and enrollees seven times in her speech, while making the case for work requirements. Her speech included no specifics on what percentage of Medicaid enrollees were considered "able-bodied."

Critics have called claims that healthy adults are bilking the program a red herring, and studies have shown that the numbers of "able-bodied" adults who are on Medicaid are relatively low, and can be explained by other factors, such as leaving the workforce to act as a caregiver.

John Commins is a senior editor at HealthLeaders.

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