Republicans postpone Medicaid work requirement application, cite concerns over exemptions

The Department for Medical Assistance Services had been aiming to submit its Medicaid work requirement waiver to the federal government by Nov. 4, as they were directed to do in the state budget.

But the deadline came and went, and no request reached the federal Centers for Medicare & Medicaid Services.

Sen. Emmett Hanger, R-Augusta, said that he, Sen. Tommy Norment, R-James City, and Del. Chris Jones, R-Suffolk, felt they needed more time to review and tweak the waiver. They asked DMAS to postpone submitting it on Nov. 2.

“We’re very, very pleased with the work of the administration, particularly with DMAS and Dr. (Jennifer) Lee and her staff,” Hanger said in an interview. “I felt that we’d be better served to take a little time to review it.

“The whole issue of Medicaid expansion is something that is mildly politically volatile in that there are still members that don’t agree and so we want to make sure that when we do move forward we’re doing it in such a way that we don’t give detractors an opportunity to say, ‘Huh that wasn’t a good idea.'”

An alert at the top of the DMAS website addresses the delay in submitting the application, noting that, “DMAS leaders have been accessible and open to discussions with legislators about the waiver application, and the agency remains ready to have those conversations in the coming days.”

The federal government most approve the application before a work requirement — or any of the other changes outlined in the waiver, such as a housing benefit — can be implemented.

Some of the concerns the lawmakers have revolve around the numerous exemptions to the work requirement listed in the waiver.

“Just because someone has a certain condition doesn’t necessarily mean that they shouldn’t, and that it wouldn’t be better for them to be preparing themselves for work, so they’d be better able to support themselves,” Hanger said. “We had some back and forth about categories of hardship exemptions and permanent exemptions and most of that has been sorted out now.”

One example is the exemption for victims of domestic violence.

“While the circumstance itself is something that, yes, it should be an exemption, at least at certain points, it would not necessarily be something that would be long-term or permanent because that individual would be better served in most instances by us assisting them in getting job skills and getting housing options and then working, and then continuing to qualify for medical benefits,” Hanger said of domestic violence.

He said he hopes the lawmakers should be done with the review soon, though he couldn’t say exactly when.

“I’m quite anxious to continue the process,” he said, adding that it may take time to negotiate the work requirements with the Centers for Medicare & Medicaid Services.

Republicans have expressed their frustration with the work requirements, a part of the Medicaid expansion deal forged with Gov. Ralph Northam and his fellow Democrats in the General Assembly. They’ve complained about the timeline, as it could take one to two years before it’s implemented once the waiver actually reaches the federal government.