WASHINGTON -- Seema Verma, the Trump administration's top Medicaid official, Tuesday sharply attacked critics of her plan to force some Medicaid enrollees to work, a policy that led to thousands of people losing coverage in Arkansas.
"We cannot allow those who prefer the status quo to weaponize the legal system against state innovation," the administrator of the Centers for Medicare & Medicaid Services said in a fiery speech to the nation's 56 state and territorial Medicaid directors in Washington, D.C.
A federal judge shut down the short-lived work requirement initiative in Arkansas and stopped it from launching in Kentucky last spring. Several states including Indiana, Arizona and New Hampshire that had won federal approval have put their implementation plans on hold pending an appellate court ruling.
Advocates for the poor argue work requirement policies are illegal and unfairly add hurdles to people who qualify for coverage in the federal-state health program.
But those opponents are seeking "to manipulate Medicaid into the prototype of a single-minded, single-payer nirvana -- a utopia of open-ended government run healthcare," Verma said. "Part of my mission is to fight such under-handed tactics and preserve the right of states to shape your programs in ways that are consistent with the needs of your residents, your cultures and your values. Anything less stifles innovation."
That would be "a disservice to the millions of people on Medicaid today and those who will need it in the years and decades to come," she added.
The federal government has approved work requirement plans in 10 states and requests are pending from 10 others. Most of those initiatives are directed at the low-income adults who gained coverage through the Medicaid expansion initiated by the Affordable Care Act.
Verma first announced plans to open the door to work requirements in a speech to Medicaid directors in 2017.
Medicaid -- like Medicare -- is an open-ended entitlement program, which means federal funding increases as costs and enrollment rise.
In addition to doubling down on the controversial work requirements, Verma renewed her interest in letting states get Medicaid funding through a block grant system. Block grants would give states more flexibility to limit enrollment and enforce eligibility rules, she added.