Trump administration approves Medicaid work requirements in South Carolina

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The Trump administration will allow South Carolina to impose work requirements on certain Medicaid beneficiaries, state and federal officials announced Thursday.

South Carolina restricts Medicaid eligibility to only its poorest residents, meaning it is poised to become the first state to impose work requirements on people who earn below the federal poverty level.

“South Carolina’s economy is booming, wages are up, and our unemployment rate is at an all-time low,” Gov. Henry McMaster (R) said in a statement. “Competition for workers is fierce and businesses are struggling to fill vacancies. In this economy there is no excuse for the able bodied not to be working.”

Under South Carolina’s requirements, adults on Medicaid will need to work or volunteer at least 80 hours a month, beginning no earlier than next December, in order to keep their eligibility.

Unlike other states that have tried to impose work requirements, South Carolina won’t completely end Medicaid benefits for people who don’t comply.

Instead, people who can’t meet the requirements for three consecutive months will have their benefits suspended until the work requirements are met, and will be able to re-enroll whenever they can prove their compliance.

Single parents who are caregivers for children will have to apply for an exemption, but one adult in two-parent families will still need to meet the requirements.

“South Carolina’s requirements — complete with appropriate protections — will lift South Carolinians out of poverty by encouraging as many as possible to participate in the booming Trump economy,” Seema Verma, Centers for Medicare and Medicaid Services administrator, said in a statement. 

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.

South Carolina’s own estimates found that 7,100 beneficiaries could lose their coverage as a result of the requirements. However, the state’s approval letter noted that the actual coverage impact “will greatly depend on the choices made by each individual.”

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. 

The state will join Wisconsin as the only non-expansion state to gain approval for work requirements, although Wisconsin will allow coverage for people earning up to 100 percent of the poverty level.

The Trump administration has made state innovation a priority and has promised to fast-track Medicaid waivers, especially those that will impose work requirements on beneficiaries. The administration has approved 10 states so far, but has suffered a series of setbacks.

A federal judge blocked implementation of work requirements in Kentucky and Arkansas, and an appeals court recently seemed skeptical of the administration’s arguments in the case.

New Hampshire suspended its work requirements last summer, and they were also later blocked by a judge.

Indiana and Arizona have also suspended their work requirements in the face of expensive lawsuits, and Virginia is moving to drop work requirements after Democrats took full control of the state legislature.

Advocacy groups and Democratic lawmakers were quick to denounce the South Carolina approval. 

“South Carolina already has one of the strictest Medicaid programs in the country,” said Sen. Ron Wyden (D-Ore.). “Thanks to Trump, new and existing parents stand to lose their health coverage unless they hack their way through arbitrary and slapdash paperwork requirements.”

“Even after similar work requirement laws were recently struck down by the courts and proven ineffective, the Trump administration continues to be hellbent on pursuing this draconian policy that put Americans’ health care in harm’s way,” said Brad Woodhouse, executive director of Protect Our Care. 

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