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CMS is skirting the rules on Medicaid waivers

The Trump administration is approving Medicaid work requirements but isn't requiring states to assess the impacts of those policies on their programs, the Los Angeles Times' Noam Levey reports. That appears to violate Obama-era rules that govern the program.

The big picture: Of the 17 states that have sought federal permission to add work requirements to their Medicaid programs, 9 have not included estimates of how many people would lose their coverage as a result.

  • And in the 8 states where work requirements have already been approved, none has a plan in place to track whether Medicaid recipients find jobs, per the L.A. Times — even though that's the stated goal of this entire endeavor.
  • That would seem to contravene 2012 rules that said waiver requests like these need to include "an estimate of the expected increase or decrease in annual enrollment," though the federal Centers for Medicare & Medicaid Services told the LAT that no such rules apply.

Quick take: This could complicate the Trump administration's job as it defends work requirements in court, where it has to show that the new restrictions are consistent with Medicaid's goals as a health care program.

Go deeper: States are using Medicaid to target social needs