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What records do I need to keep? When do I report an incident? Incidents that happen in Northern Ireland should be reported to HSE NI. HSE aims to reduce work-related death, injury and ill health. 4 5 1 4 1 2 1 . Seema Verma, left, the administrator of the federal Centers for Medicare and Medicaid Services, at the White House last year. WASHINGTON — The Trump administration said on Thursday that it would allow states to impose work requirements in Medicaid, a major policy shift that moves toward fulfilling a conservative vision for one of the nation’s largest social insurance programs for low-income people.

Seema Verma, the administrator of the federal Centers for Medicare and Medicaid Services. Verma said the Trump administration was responding to requests from Medicaid officials in 10 states that wanted to run demonstration projects testing requirements for work or other types of community engagement like training, education, job search, volunteer activities and caregiving. Under the new policy, Trump administration officials would allow work requirements in Medicaid somewhat similar to those already imposed in other programs like food stamps, now known as the Supplemental Nutrition Assistance Program, and the welfare program known as Temporary Assistance for Needy Families. In a speech to state Medicaid officials in November, Ms. Verma indicated that the Trump administration would be receptive to work requirements and other conservative policy ideas to reshape Medicaid. And she criticized the Obama administration, saying it had focused on increasing Medicaid enrollment rather than helping people move out of poverty and into jobs. The Medicaid proposals came from Arizona, Arkansas, Indiana, Kansas, Kentucky, Maine, New Hampshire, North Carolina, Utah and Wisconsin.

Several other states are considering work requirements. In one state, Kentucky, the waiver application seeks to require most non-disabled Medicaid beneficiaries age 19 to 64 to work at least 20 hours a week. They could meet the requirement through not just paid employment, but also volunteer work, job training, searching for a job, going to school or taking care of someone elderly or disabled. Pregnant women, full-time students and primary caretakers of children under 19 or disabled adult dependents would be exempt from the state’s work requirement, as would people deemed medically frail.

Advocates for Medicaid beneficiaries said the new policy was likely to be challenged in court if people were denied coverage for failure to meet a state’s work requirement. In the past, federal officials said that work was not among those objectives. But Trump administration officials said on Thursday that work requirements were consistent with the goals of Medicaid, because work and work-related activities could improve the health of Medicaid beneficiaries. Brian Neale, the director of the federal Medicaid office, said on Thursday in a letter to state Medicaid directors. For example, higher earnings are positively correlated with longer life span. Medicaid beneficiaries could work at a variety of jobs — as cashiers, telemarketers, housekeepers, nursing and home health aides, child care providers, cooks and dishwashers, waiters and waitresses, retail sales clerks, landscapers, security guards and construction laborers, for example. They could also work as volunteers at food pantries and other charitable organizations.

The Trump administration said that states imposing work requirements must have plans to help people meet those requirements and should help arrange job training, child care and transportation as needed. A Year Later, Trump Is Less Popular Across Voting Blocs. President Trump’s approval rating fell across many demographic groups over his first year in office, including among those seen as important to his base. Medicaid has a major role in combating the opioid epidemic, paying for a work requirements range of treatments and medications. But people addicted to opioids are often unable to work or to find jobs, and some employers are reluctant to hire people who fail drug tests.

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For example, she said, time spent in medical treatment for opioid addiction might be counted toward compliance with a state’s work requirement. The Trump administration said that state Medicaid officials could not impose work requirements on pregnant women, elderly beneficiaries, children or people who were unable to work because of a disability. Despite such exemptions, Democrats called the new policy inhumane, meanspirited and malicious, echoing criticism of work requirements in a welfare law adopted in 1996. Trump administration’s war on health care. Advocates for Medicaid beneficiaries said that work requirements would harm some people who are unemployed, making it more difficult for them to obtain the health care they need. Hannah Katch, a policy analyst at the liberal-leaning Center on Budget and Policy Priorities.

But the new policy is exactly what some Republican governors were seeking. In his State of the State address on Tuesday, Gov. It will actually help this population reap the rewards of a good job, and one day receive health care coverage from their employer, not the state or federal government. Dennis Daugaard of South Dakota, a Republican, said he would seek a waiver for a work requirement that could affect 4,500 people. There’s a sense of pride that comes with having a job to do and being able to provide for your family. The federal government and states generally share the cost of Medicaid and could save money if enrollment goes down because of work requirements. White House officials say Medicaid spending is growing at an unsustainable rate, and last year President Trump supported bills that would have cut hundreds of billions of dollars from projected Medicaid spending over 10 years.

350 billion on the program in the last fiscal year, the Congressional Budget Office says. A version of this article appears in print on , on Page A1 of the New York edition with the headline: U. Supports Requiring Work To Get Medicaid. Can Requiring People to Work Make Them Healthier?

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