Some states clamored for work requirements for Medicaid recipients once the Trump Administration opened the door. After Kentucky’s approval and legal challenge, a work requirement waiver has also been approved in Indiana. Their newly approved waiver includes burdensome premiums and co-pays, locks individuals out of re-enrollment when they do not pay premiums or fail to comply with administrative requirements, imposes onerous waiting periods for eligibility, and includes a burdensome, complex, and costly work requirement program. As pointed out by the National Health Law Program, “a mandatory work requirement is not medical assistance; it is not a service provided to Medicaid beneficiaries.” The health consequences of losing coverage are too severe to remove people’s insurance as a punishment for not being able to find a job. Indiana’s waiver approval comes after reports that premium requirements resulted in 25,000 Medicaid recipients losing coverage due to failure to pay premiums. An additional 46,000 low-income adults never received Medicaid benefits because they didn’t pay the initial premium. At least one lawsuit challenging the administration’s approval of these waivers has been filed.

Closer to home, Oregon voters overwhelmingly approved a ballot measure to support Medicaid in late January! Last year, Oregon’s Legislature passed a tax package to ensure funding for the Medicaid expansion as federal funding began to ratchet down from 100%. (The federal funding is scheduled to hit 90% and hold steady beginning in 2020.) The tax package included taxes on hospitals and insurers; voters used the initiative process to force a public vote due to concerns about the taxes being passed on to consumers. Oregon has one of the lowest uninsured rates (5%) in the country due to the Medicaid expansion.