WASHINGTON -- After allowing states to impose work requirements for Medicaid enrollees, the Trump administration is now pondering lifetime limits on adults' access to coverage.
Capping health care benefits -- like federal welfare benefits -- would be a first for Medicaid, the joint state and federal health plan for low-income and disabled Americans.
If approved, the dramatic policy change would recast government-subsidized health coverage as temporary assistance by placing a limit on the number of months adults have access to Medicaid benefits.
The move would continue the Trump administration's push to inject conservative policies into the Medicaid program through the use of federal waivers, which allow states more flexibility to create policies designed to promote personal and financial responsibility among enrollees.
However, advocates say capping Medicaid benefits would amount to a massive breach of the nation's social safety net designed to protect children, the elderly and the impoverished.
In January, the Trump administration approved waiver requests from Kentucky and Indiana to terminate Medicaid coverage for able-bodied enrollees who do not meet new program work requirements. Ten other states have asked to do the same.
"We must allow states, who know the unique needs of their citizens, to design programs that don't merely provide a Medicaid card but provide care that allows people to rise out of poverty and no longer need public assistance," said a statement posted on Twitter on Monday by Medicaid administrator Seema Verma.
At least five states -- Arizona, Kansas, Utah, Maine and Wisconsin -- are seeking waivers from the Trump administration to impose lifetime Medicaid coverage limits.
The proposals reflect the administration's belief that Medicaid coverage should be retained for vulnerable populations like children, pregnant women and those with disabilities. Proponents of the change say the program's coverage for healthy adults, particularly those with no dependent children who received expanded coverage under Obamacare's Medicaid expansion, should be curbed.
Critics, however, say Medicaid time limits will pose an enormous administrative burden by requiring states to track recipients' employment, eligibility and disability status. It could also shave valuable coverage months from people with health problems that impede their ability to work.