On Wednesday, April 19^th, Speaker of the House Kevin McCarthy (R-CA) unveiled legislation that would raise the United States debt ceiling in addition to implementing cost reduction measures on Federal spending. In addition to broad limits on domestic discretionary spending, the legislation would implement work requirements for certain Medicaid beneficiaries.

Under the legislation, individuals between the ages of 19 and 56 would be required to document that they worked for a minimum of 80 hours a month or were excluded from the requirements due to a factor such as:

• An inability to work documented by a physician or medical professional;
• Participation in an educational or work training program;
• Responsibility to care for a child or an “incapacitated” person.

The legislation allows, but does not require, states to continue covering these individuals in their Medicaid programs and denies Federal funding for any services delivered to a participant that was not in compliance with the requirements.

Prior to the legislation’s release, NAHC sent a letter to the Speaker expressing concerns about the reporting requirements potentially leading to disenrollment of people with disabilities and chronic conditions who would otherwise be exempt from the requirements. In the letter, NAHC requested that the legislation include a requirement that states review Medicaid claims data and issue an automatic exclusion for anyone who has utilized home health, personal care, hospice, and/or home and community-based services in the past 24 months. Such an exclusion would ensure that anyone with a condition significant to require these types of services is appropriately exempt from the requirements.

Notably, although the Speaker has expressed plans to pass the legislation in the near future, the Senate will not take up the legislation and the policies contained within are extremely unlikely to be enacted.