The change was announced during the State Medicaid Advisory Committee meeting in Phoenix on Wednesday.
The announcement comes after CMS rejected Kansas’ request for a 3-year lifetime limit on Medicaid benefits.
Arizona’s Medicaid program, the Arizona Health Care Cost Containment System, is obligated by a 2015 statute to annually request a waiver from CMS to impose work requirements and a lifetime limit on Medicaid benefits. AHCCCS submitted its Section 1115 Waiver December 19, 2017.
AHCCCS Deputy Director Jami Snyder said the 5-year lifetime limits portion of the AHCCCS Works waiver was tabled after contacting CMS April 6 and receiving approval of the waiver’s communication engagement requirements. In January 2018, CMS announced it would assist states to incentivize work and community engagement among non-elderly, non-pregnant adult Medicaid beneficiaries who are eligible for Medicaid on a basis other than disability.
Proposings lifetime limits on Medicaid benefits produced push back from many patient advocates including the Arizona Academy of Family Physicians, which publicly commented,
“A five-year lifetime limit would force many to be uninsured, limit their access to primary, preventive, acute and chronic care that our members so ably provide. It would shift the cost of care to family physicians and other health providers and dramatically increase uncompensated and charity care…”
More comments to AHCCCs on the AHCCCS Works waiver can be read here:
AHCCCS Works applies to able bodied adults 19-49, with exceptions. To qualify for AHCCCS benefits those subjected to AHCCCS Works must for at least 80 hours a month:
- Be employed or actively seek employment
- Attend School or
- Participate in employment support and development activities.
CMS Administrator Seema Verma expressed support for state’s interests in making work requirements a part of Medicaid policy saying, “We will continue to be supportive of state efforts to help able-bodied, working-age adults rise out of poverty, so they can gain the skills they need to fill the jobs that are available.”
CMS has approved Medicaid work requirements in Kentucky, Indiana, Arkansas and New Hampshire.
“With almost 400,000 qualifying adults enrolled, it is important that Medicaid evolve to meet the needs of this population and give them the tools necessary to obtain gainful employment when a path to such employment exists,” wrote Director Tom Betlach in the state’s waiver amendment request to CMS for AHCCCS Works.
The logistics of managing work requirements won’t just fall to state Medicaid agencies, according to a new Price Waterhouse Coopers report.
“Managing requirements means developing new operational and technical skills. With new requirements comes key questions about how states will devise systems to evaluate eligibility as well as what Medicaid managed care organizations (MCOs) need to do to confirm eligibility. While the initial burden will fall to the state, MCOs will be responsible for ensuring internal systems and processes for evaluating eligibility requirements are met and coordinated with the state.”