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Arizona’s Medicaid program may soon have a work requirement

(Flickr/U.S. Army Corps of Engineering)

PHOENIX — A work requirement may soon be added to Arizona’s Medicaid program.

The state plans to submit a formal waiver to the federal government before the end of December that would request to add a work requirement to the Arizona Health Care Containment System, also known as AHCCCS.

“The work requirement will ask beneficiaries to either be employed for up to 20 hours a week or serve in a volunteer capacity in their communities,” said Heidi Capriotti, spokeswoman for AHCCCS.

Some people would be exempt from the work requirement, including people who are 55 and older, women who are pregnant, former foster youth under the age of 26 and individuals with a serious mental illness.

Capriotti said by submitting the waiver, the state is complying with a bill Gov. Doug Ducey signed into law in 2015 that requires AHCCCS to seek permission from the federal government to add a work requirement on AHCCCS recipients, as well as to seek a lifetime limit on Medicaid benefits.

The waiver the state will submit to the federal government will also include a request to add a five-year lifetime limit on coverage for AHCCCS.

AHCCCS Director Tom Betlach outlined the work requirements that the state plans to include in its waiver in a letter to the Centers for Medicare and Medicaid Services, the federal agency that will ultimately decide if the wavier is approved.

Betlach said able-bodied adults would need to verify they are employed, going to school, or attending an employment support and development program for at least 20 hours a week.

The definition of an employment support and development program would include job training programs, English as a second language courses and parenting classes.

Beneficiaries who fail to meet the work requirement would be given 6 months to be in compliance. Failure to comply could result in getting dropped from AHCCCS, but beneficiaries would be able to re-enroll after demonstrating compliance for 30 consecutive days.

This also came as a study by the Kaiser Family Foundation found 80 percent of AHCCCS beneficiaries had at least one family member who was working in 2016, but was not making enough to be able to afford health insurance.

Meanwhile, health advocates are worried about how the work requirements would be implemented.

Will Humble, executive director for the Arizona Public Health Association, said he’s concerned about how people would need to report to AHCCCS to prove they are meeting the work requirement.

“If the reporting requirements are challenging or not convenient, then a lot of people could easily roll off of their benefits unknowingly,” Humble said.

He added that if AHCCCS implements easy steps people can take to comply, then it might not be that big of a problem.

“But if it’s done in a way that makes it difficult to comply, we could see a whole lot Medicaid members losing their benefits for no other reason than they didn’t understand how and where they were supposed to report,” he said.

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