Oklahoma seeks Trump approval on Medicaid work requirements

The Trump administration is set to consider Oklahoma’s plan for work requirements in its Medicaid program, as the state formally submitted its request late last week.

If the Centers for Medicare and Medicaid Services approves the request, certain “able-bodied” Medicaid beneficiaries will be required to work, volunteer, or go to school for 80 hours a month beginning Feb. 1. If they fail to meet the requirements for three months, they will have their coverage removed until the requirements are met.


People younger than 19 and older than 50 would be exempt under the proposal, as would pregnant women, parents of children younger than 6 and people who can prove a disability. The state estimated that only about 6,000 people would be impacted by the requirements.

“The correlation between employment and health for the general population is well established,” the state said in a notice announcing the waiver submission.

If approved, Oklahoma would join Wisconsin as the only other state that did not expand Medicaid under ObamaCare but still chose to impose work requirements on Medicaid recipients. Oklahoma’s eligibility requirements are also some of the strictest in the nation.

The non-pregnant, able-bodied individuals under age 65 who qualify for Medicaid can only earn up to 41 percent of the federal poverty level. This means parents are eligible for Medicaid if the family income is less than $9,351 per year for a family of three. A family of two (one parent and one child) would be inelegible if it earned more than $6,750 a year.

Health advocates have lashed out over work requirements in nonexpansion states like Oklahoma. They argue people who don’t work will lose coverage, but the people who do work will likely earn too much money in order to qualify under the state’s strict requirements, and will not be offered employer-sponsored insurance.

Oklahoma is also only one of two states with an uninsured rate above 14 percent. Nationally, according to the most recent census figures, the average uninsured rate was 8.7 percent in 2017.

The Trump administration has approved work requirements in Arkansas, Indiana, Kentucky, New Hampshire and Wisconsin, though Arkansas's work requirements are being challenged in court.