Maine, Wisconsin Pursue Additional Requirements for Medicaid Eligibility

Maine and Wisconsin officials have announced plans to implement reforms mandating proof of employment, substance sobriety, and other requirements among Medicaid participants, according to releases from each state’s health department.

These amendments would reduce program cost while promoting individual responsibility among the “childless adult” and “able-bodied” population, the health departments wrote. 

“These reforms align with our mission of ensuring our most vulnerable populations have access to health care, while also working to promote healthy living, and further enabling the transition to the workforce for those able to work.” Wisconsin Medicaid Director and Administrator Michael Heifetz said in a release.

Following public hearings and comment submission, Wisconsin’s Department of Health Services (DHS) and Maine’s Department of Health and Human Services (DHHS) will submit a formal request to the U.S. Department of Health and Human Services requesting amendments to the provisions of each state’s Section 1115 Demonstration Waiver. The DHS and DHHS’ reforms have the support of Governor Scott Walker and Governor Paul LePage, respectively.

“These are commonsense guidelines that ensure able-bodied adults are utilizing the program appropriately,” Mary Mayhew, commissioner of the DHHS, said in a release. “Under Governor LePage, we have successfully reined in spending within the MaineCare program that once failed to prioritize our neediest citizens and placed an undue burden on Maine taxpayers, and we look forward to continuing those efforts with the opportunity extended to us by the federal government through this waiver.”

Specifically, Wisconsin’s proposed amendments would implement mandatory drug screening, work requirements and benefits, monthly household premiums, increased emergency room copays, and rewards for healthy behavior. Reforms proposed in Maine also include work or work-seeking requirements and monthly premiums, as well as fees for missed appointments, elimination of retroactive coverage for applicants, and the inclusion of personal assets when determining program eligibility.

“With our Medicaid program finally on stable financial ground and a new administration in Washington, we have an opportunity to reshape our program and tailor it to best serve the needs of our state,” Ms Mayhew said. “We must reestablish Medicaid’s core mission of supporting the elderly, disabled, and children. This is what is best for the people of Maine and the future of our state.” —Dave Muoio