Biden administration confirms plan to end Wisconsin Medicaid work requirement

MM Curator summary


Biden’s CMS is “withdrawing approval” of waivers previously approved by CMS.


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A work requirement for some BadgerCare recipients — which was already on hold during the COVID-19 pandemic — has been eliminated, the federal government has confirmed.

The work requirement was part of a Medicaid waiver for which the administration of former Gov. Scott Walker received approval in 2018. It had not been implemented before the COVID-19 pandemic, when it was suspended, and now will not be implemented at all.

The Center for Medicare & Medicaid Services (CMS) in the federal Department of Health and Human Services told the Wisconsin Department of Health Services (DHS) in a letter on Tuesday that it was withdrawing permission for the state to impose the requirement.

“CMS has determined that, on balance, the authorities that permit Wisconsin to require work and community engagement as a condition of eligibility are not likely to promote the objectives of the Medicaid statute,” the letter states.

The “community engagement requirement” specified that adults without children who applied for BadgerCare would have to document at least 80 hours a month of either work, education, job training or community service in order to stay eligible for health coverage.

The requirement was enacted in Walker’s 2015-17 budget; under the Trump administration, CMS approved it in October 2018. The next month, Walker lost-reelection, but before leaving office he signed legislation that blocked incoming Gov. Tony Evers from canceling the requirement. DHS began preparing to implement it, but the requirement was put on hold in March 2020. A federal law that gave states a 6.2% boost in their Medicaid dollars during the federal public health emergency required them not to kick any Medicaid recipients off the program in return for the funds.

Less than a month after President Joe Biden’s inauguration, the incoming federal administration indicated it would probably withdraw the Trump administration’s authorization of work requirements in Wisconsin and other states.

Although the Walker administration justified the requirement as a means to foster independence and encourage people to work, courts in other states have overturned such restrictions, ruling the goal of the original federal Medicaid law was solely to expand health insurance access, not encourage employment.

Research has found that most people on Medicaid who are able to work are already working, and that most of the people excluded by a work requirement qualified but couldn’t keep up with the task of filing regular reports to verify their work status. “In short, work requirements don’t help work, but they do push people off health insurance,” Donald Moynihan, a professor of public policy at Georgetown University and former director of the Robert M. La Follette School of Public Affairs at the University of Wisconsin, told the Wisconsin Examiner earlier this year.


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