States Spending Millions to Administer Medicaid Work Requirements
Health Care

States Spending Millions to Administer Medicaid Work Requirements

Karen Pulfer Focht

States deploying work requirements in their Medicaid programs are spending millions of dollars on administrative costs to implement the new rules, according to a new study by the Government Accountability Office.

Examining the first five of the nine states that have received waivers from the Trump administration to put work requirements into place, the GAO found they are spending anywhere from $6 million to more than $270 million to implement their programs. And the ultimate price tags may be higher in the end, since not all administrative costs were available.

Much of the cost is related to information technology, the majority of which is paid for by the federal government. For example, Kentucky expects to spend roughly $220 million on IT in 2019 and 2020 as part of its $271 million outlay.

GAO criticized the Centers for Medicare & Medicaid Services for failing to consider the costs of implementation when evaluating state requests for waivers. “[T]he cost of administering demonstrations, including those with work requirements, is not transparent to the public or included in CMS's assessments of whether a demonstration is budget neutral—that is, that federal spending will be no higher under the demonstration than it would have been without it,” GAO said.

The study was requested by Senate Finance Committee Ranking Member Ron Wyden (D-OR) and House Energy and Commerce Committee Chairman Frank Pallone, Jr. (D-NJ), critics of the Trump administration’s approval of state-level work requirements for Medicaid recipients.

"This study confirms that the Trump administration is allowing states to waste taxpayer dollars in the pursuit of ideological changes to Medicaid that hurt vulnerable Americans," Wyden and Pallone said in a statement.