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Questionnaire NameAlabama Medicaid Workforce Initiative
DescriptionAlabama requests a new 5-year section 1115 demonstration which seeks to require community engagement as a condition of continued Medicaid eligibility for able-bodied parent or caretaker relative beneficiaries to improve beneficiary health outcomes and economic stability. Beneficiaries will be required to participate in 35 hours a week of community engagement activities unless the beneficiary is a parent or caretaker relative with a child under 6 years of age, lowering the requirement to 20 hours per week. Failure to comply with the requirements will result in termination of Medicaid benefits. The state is proposing a number of exemptions and exceptions. The federal public comment period will be open from September 21, 2018 through October 21, 2018.
Response FromID: #378477 on Sep 22nd 2018 1:00 am
Alabama Medicaid Workforce Initiative

Alabama Medicaid Workforce Initiative

We encourage the public to submit their comments on Medicaid.gov as they relate to demonstrations open for public comments. In support of transparency and open government, all public comments received are immediately posted and are in the public domain. Center for Medicaid and CHIP Services staff will review all public comments posted and we reserve the discretion to delete comments that are generally understood as any of the following: obscene, profane, threatening, or otherwise inappropriate.

Refer to the Application

Open for Public Comment – 9/21/18 – 10/21/18

Please provide your comments here and/or attach below:

I am writing in my capacity as a public health researcher and concerned citizen to argue against the proposed waiver. All available evidence indicates that imposing "community engagement" requirements will not benefit Medicaid beneficiaries, and that it will result in people who need Medicaid the most being dropped from the program. In short, the practical effect of this policy would run directly counter to the policy goals of the Medicaid program. Given the extreme level of poverty required to qualify for Medicaid in Alabama in the first place, it is likely that burdensome reporting requirements associated with a "community engagement" requirement would be very difficult for many beneficiaries to meet (due to lack of internet access, transportation, etc).

There is no policy goal supported by the proposed waiver that is consistent with the purpose, or statutory authority, underlying the Medicaid program. All it will do is harm potential beneficiaries, their communities, the hospitals that serve them (who will be stuck providing higher levels of uncompensated care), and Alabamans who *do* have insurance (because they will be forced to pay higher premiums to subsidize that uncompensated care). I therefore strongly urge CMS to deny approval for the Alabama Medicaid Workforce Initiative.
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