State expects Medicaid work requirement approval no later than the summer

State social services workers signed up homeless residents for Medicaid at a resource fair in Richmond in early November. (Ned Oliver/ Virginia Mercury)

Despite courts blocking Medicaid work requirements in other states, Virginia’s proposed program is still slowly working its way toward federal approval.

The state expects the federal government will sign off on its work requirement program no later than the summer, said Karen Kimsey, chief deputy director of the Department of Medical Assistance Services, which manages Medicaid in Virginia.

The state submitted its work requirement application to the federal government in November after receiving 1,800 public comments (the vast majority of which were against the program). Since then, the federal government held a public comment period of its own before certifying Virginia’s application and starting negotiations with DMAS.

The negotiations, Kimsey said, largely involve ironing out the details, like how many federal dollars the state can put toward which activities.

“Significant turnover” in terms of staffing at the federal level, she said, has slowed down the process a bit.

But looming over the negotiations are a federal judge’s ruling blocking work requirement programs in Kentucky and Arkansas — for the second time. The Centers for Medicare & Medicaid Services appealed the decision.

Kimsey said that, while Virginia is closely tracking court decisions and pending litigation, “At this time it does not have an impact on us in terms of moving forward.”

In Arkansas, more than 18,000 Medicaid enrollees have lost coverage, not because they’re not working, but because they simply did not know how, or could not, report their work to the state.

Kimsey noted that Virginia has the benefit of seeing the “lessons learned” from other states, particularly Arkansas, in determining how to implement its program.

Virginia’s Republican lawmakers have expressed frustration at the time frame attached to getting a work requirement program up and running in the state. DMAS Director Dr. Jennifer Lee told them last year it could take up to a year to receive federal approval and then potentially another year for implementation.

Virginia’s proposed program, which includes cost-sharing requirements for some populations, offer a slew of exemptions for those who cannot work, such as people with disabilities or full-time caregivers. It also has a housing component.