South Carolina is seeking permission from the Trump administration to impose work requirements on Medicaid beneficiaries.
The state on Monday formally submitted a request to require Medicaid recipients to work, be enrolled in job training or be in school an average of 80 hours a month.
The Trump administration has made it a priority to approve conservative Medicaid waivers for states that apply for them, but has run into opposition in the federal court system.
The administration has also approved Medicaid work requirements in Arizona, Kentucky, Michigan, New Hampshire, Indiana, Ohio and Wisconsin, but many have not yet been implemented. Kentucky’s requirements have also been blocked in federal court, and are prohibited from taking effect.
Unlike other states that have tried to impose work requirements, South Carolina won’t completely end Medicaid benefits for people who don’t comply, and won’t force beneficiaries to re-enroll in the program if they lose their benefits.
Instead, people who can’t meet the requirements for three consecutive months will have their benefits suspended for three months, or until the work requirements are met, whichever comes first.
Exemptions for the requirements will be granted to disabled adults, full-time caregivers, pregnant women, anyone over age 65, and others.
South Carolina Gov. Henry McMaster (R) directed the state to seek a waiver for work requirements in January 2018. He argued, like other supporters of work requirements, that employment will help improve the health and general well-being of the “able-bodied” adult population.
If approved, the requirements won’t take effect until at least July 1, 2020.
One of the main criticisms of work requirements is that they are merely a way to eliminate people from the Medicaid rolls and trim state health care spending.
According to South Carolina’s own analysis, more than 11,000 individuals are estimated to lose coverage over the course of the five-year demonstration period.
Unlike many of the other states that already have been granted permission for work requirements, South Carolina did not expand Medicaid under ObamaCare.
Adults in the state who are able to qualify for Medicaid must earn below 67 percent of the federal poverty level — which is $12,490 for an individual, or $21,330 for a family of three. To date, Wisconsin is the only non-expansion state to win approval for work requirements.
ObamaCare allowed states the option to expand Medicaid to childless low-income adults, and 36 states and D.C. have done so.
But the Trump administration has argued that these "able-bodied" adults should be working instead, and that only society's most vulnerable should be eligible for Medicaid.