The Centers for Medicare & Medicaid Services (CMS) has approved Ohio’s Section 1115 demonstration waiver, which makes work requirements a condition of eligibility for certain Medicaid beneficiaries in the state.
Ohio’s waiver requires beneficiaries ages 18 to 49 who are eligible through Medicaid expansion to work or participate in other community engagement activities for at least 80 hours a month. Failure to comply or report compliance will result in termination of Medicaid eligibility.
The waiver exempts certain groups of individuals, many of whom are also exempt from existing work requirements through other federal programs. Exempt groups include:
- individuals ages 50 or older;
- individuals who are physically or mentally unfit for employment;
- caretakers for a disabled or incapacitated household member;
- pregnant women;
- parents, caretakers, or individuals residing in the same house as a minor child;
- individuals who have applied for or are receiving unemployment compensation;
- students in school at least half-time;
- individuals participating in drug or alcohol treatment;
- applicants for or recipients of Supplemental Security Income;
- participants in the Specialized Recovery Services Program; and
- eligible incarcerated individuals.
The waiver approval comes one day after CMS released guidance on monitoring and evaluation in Medicaid waivers, including those with work requirements.
Contact Senior Director of Policy Erin O’Malley at firstname.lastname@example.org or 202.585.0127 with questions.