Gov. Jeff Colyer affirmed enthusiasm Monday for adding a work requirement for able-bodied adults to Kansas’ Medicaid program despite a decision by the federal government to block the state’s proposal to initiate a three-year lifetime benefit cap.
Officials with the Centers for Medicare and Medicaid Services in the administration of President Donald Trump announced rejection of the lifetime limit. CMS Administrator Seema Verma told the American Hospital Association’s annual meeting such limits, including Kansas’ proposed 36-month rule, could prematurely block the pathway of people striving to be healthy and emerge from poverty.
Verma said circumstances of individuals in Medicaid changed and “we must ensure that our programs are sustainable and available to them when they need and qualify for them.”
On Monday, Colyer said the state received a letter from CMS affirming rejection of a lifetime cap proposed in October under recommendations for reform the state’s Medicaid program, known as KanCare. The program serves more than 400,000 residents of the state.
In April, Colyer said the state reacted to criticism of a lifetime cap by agreeing to withdraw that provision from the blueprint for KanCare 2.0, which had been the target of bipartisan skepticism among state lawmakers. So far, CMS hasn’t endorsed KanCare 2.0.
“The decision to remove lifetime caps was made after a series of discussions with CMS in which they indicated they would be unable to approve the measure,” the governor said. “While we will not be moving forward with lifetime caps, we are pleased that the (Trump) administration has been supportive of our efforts to include a work requirement.”
Sheldon Weisgrau, executive director of the Alliance for a Healthy Kansas, applauded CMS’ decision on lifetime caps because the lifetime maximum of three years in Medicaid would have damaged the program’s ability to act as a safety net for vulnerable Kansans.
“Patients can now be assured that an arbitrary bureaucratic time limit would not end their health care coverage in the middle of a critical course of treatment,” Weisgrau said.
Colyer and his predecessor, Gov. Sam Brownback, had argued the work requirement and lifetime limit on Medicaid would empower people to be more self-sufficient.
Sean Gatewood, who works with KanCare Advocates Network, said the lifetime benefit idea wouldn’t have touched the vast majority of Medicaid recipients, such as the disabled and elderly. The idea touted by the Brownback-Colyer administration was to initiate the cap on an estimated 12,000 people who would also be subject to a work requirement, he said.
“The cap was probably the worst policy in KanCare 2.0 — by far — and probably the most illegal,” Gatewood said.
He said both the work requirement and lifetime benefit provisions, combined with the state’s refusal to expand eligibility for Medicaid, were contrary to the idea of helping financially fragile adults maintain good health and achieve longevity in the workforce.
Other states, including Maine, Utah and Arizona, had joined Kansas in appealing for federal permission to adopt lifetime limits under Medicaid.
CMS approved work requirements in Indiana, Kentucky and Arkansas, with anticipation more states could be added to that list.