Utah suspends controversial work requirement for Medicaid enrollees because of the coronavirus

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The Utah Department of Health on Friday suspended the self-sufficiency/work requirement for Medicaid enrollees, citing the coronavirus pandemic. The move, which could potentially remove barriers for hundreds, if not thousands of Utahns was hailed by health advocates, who said it was long overdue.

“Work requirements or ‘community engagement’ rules have always been illegal, illogical, and unnecessarily punitive,” said Stacy Stanford, policy analyst with the nonprofit Utah Health Policy Project. “These flaws are amplified during this pandemic but are also problematic even in the best of times.”

Utah is not the only state with work requirements, which have been approved under the Trump administration. But so far courts have rejected the work rules when challenged, with the issue likely headed to the U.S. Supreme Court. The Beehive State’s requirements have not been litigated.

Utah, until Friday, was the “last man standing,” with all other states that had imposed work requirements having already suspended them under federal law, Stanford said.

The nonprofit is lobbying to make the suspension permanent.

Utah’s work rules kicked in Jan. 1 under Utah’s new expanded Medicaid program, requiring adult applicants to complete an online job assessment, online training programs, and log 48 job searches within the first three months of eligibility to continue to receive benefits.

Exemptions from these requirements were available to people age 60 and older, for pregnant women or those caring for young children, people already working 30 hours per week, and students, among others. The state estimates about 70% of applicants qualify for an exemption.

But the new suspension of these mandates for the remaining 30% could affect thousands of Utahns, not to mention some people who are eligible for exemptions but fall through the cracks because it can be tough to prove such things as disability or that someone is a caregiver.

The health department said as of the end of last year, 42,900 Utahns had been added to Medicaid after the state’s earlier expansion to cover those making up to 100% of the poverty level. In January, the program expanded again to include those making up to 138% of the poverty level, opening it to potentially 50,000 additional enrollees.

The 138% of poverty cutoff for Medicaid eligibility translates to $17,609 for an individual and $36,156 for a family of four.

Kolbi Young, of the health department, said about 4,000 more people had signed up this year through the end February. But those numbers are expected to soar now with so many businesses shutting down or scaling back.

“Absolutely, across the board,” Young said.

More than 48,000 Utahns filed new jobless claims in the past two weeks — a record that may have not been seen since the Great Depression in the early 1900s, if even then.

“This is exactly what [Medicaid] is built for — to be a safety net in a crisis,” Stanford said.

State officials say suspending the requirements is the right thing to do in the face of the pandemic.

“During this time of increasing cases of COVID-19, a ‘Stay Safe, Stay Home’ directive, and rising unemployment, it is important that Medicaid members be able to continue their health coverage,” Utah Medicaid Director Nate Checketts said in a prepared statement. “Suspending the community engagement requirement during this state of emergency recognizes the unique challenges created by this public health crisis.”

While praising the state’s move to push pause, “we really hope it becomes permanent,” Stanford said.

The economic turmoil the country is seeing isn’t going to disappear overnight, even when the state of emergency is lifted, she notes. Then the question becomes, are people who signed up during the pandemic going to face retroactive work requirements? Are some going to be kicked out of the program?

“That is a concern on our radar for sure,” Stanford said.

Young said it is unlikely there would be any retroactive application of the work requirements and she said there is no end date to the suspension, so it could last as long as the economic fallout from the coronavirus lasts.

Individuals and families who need health coverage may apply for benefits at any time. Information about all Medicaid programs for low-income individuals is available on the Medicaid website at medicaid.utah.gov. Applications are accepted over the phone, by mail or online at medicaid.utah.gov/apply-medicaid.

The Utah Health Policy Project also can answer questions or offer assistance in enrolling remotely in Medicaid at healthpolicyproject.org.