Public Payers News

UT Suspends Work Requirements Due To COVID-19 Unemployment Rates

After Utah’s unemployment claims jumped 1,391 percent in one week, the state decided to suspend work requirements attached to Medicaid expansion.

unemployment, Medicaid expansion, coronavirus, Medicaid, Affordable Care Act

Source: Thinkstock

By Kelsey Waddill

- The Utah Department of Health has announced that it is suspending the community engagement requirement for its Medicaid expansion members.

The department stated that the unemployment rate resulting from the coronavirus outbreak was a primary reason for this decision.

“During this time of increasing cases of COVID-19, a “Stay Safe, Stay Home” directive, and rising unemployment, it is important that Medicaid members be able to continue their health coverage,” said Nate Checketts, director of Utah Medicaid. “Suspending the community engagement requirement during this State of Emergency recognizes the unique challenges created by this public health crisis.” 

Around 30 percent of Utah’s Medicaid expansion members qualify for the community engagement requirement, the announcement stated. The community engagement requirement went into effect on January 1, 2020. It involved a couple of components:

  • An online job assessment
  • Online training programs
  • 48 job searches in the first three months of eligibility

Many of Utah’s Medicaid expansion members were exempted from the work requirement based on one or more of thirteen criteria. For example, if a member was 60 years old or older, pregnant, was caring for young children, was working 30 hours per week, or was a student, she would be exempt from the requirement.

Now, the work requirement has been suspended altogether.

For at least three weeks now, the unemployment rate in Utah has been escalating and breaking state records.

In one week, Utah’s unemployment claims jumped 1,391 percent for the week ending in March 21 from the week before. As of March 27, 2020, almost 19,600 Utahns had filed for unemployment benefits.

Meeting work requirements is enough of a challenge in normal times, but with a number of industries closed in Utah due to the coronavirus, it could have been nearly impossible for some Medicaid expansion members.

“Due to COVID-19, Medicaid has suspended the Community Engagement (self-sufficiency/work) requirement,” Utah’s Department of Health Medicaid site announced. “Medicaid members do not need to register for work and do not need to complete the assessment, training programs, or job searches.  All members will continue to receive benefits through the end of this emergency period.”

Utah received approval from CMS to attach work requirements, or community engagement requirements, to its Medicaid program in late December.

When it passed, local news outlets recounted the tug of war between the public and Utah’s state legislature. Over 50 percent of Utahns wanted full Medicaid expansion, but the legislature feared that the proposition that the public supported would not be financially sound. The legislature sought to override the vote with a new proposition.

Ultimately, though, the state reverted to its original plan for a full Medicaid expansion, with some novel elements. Work requirements for a portion of the Medicaid expansion population were among the new aspects.

To date, CMS has approved work requirements for six states—including Utah—and 25 have work requirements pending. Four states have had their work requirements halted by the courts, most recently Michigan. That left Utah as the sole state with operational work requirements.

Due to the coronavirus, the Department of Labor’s statistics for the week ending in March 28 was bad news for the country as a whole, not just Utah.

In just a week, the number of uninsurance claims nationwide doubled from 3.3 million to 6.6 million.

Insured unemployment was the highest it had been in seven years.

States and payers are scrambling to react to the plummeting employment. Some payers, such as Health Care Service Corporation (HCSC), have extended special enrollment periods to members who chose not to enroll previously or to the spouse and dependents who were not enrolled during the previous enrollment period.

The Urban Institute found that Medicaid expansion will be crucial during the impending recession. The Affordable Care Act was able to decrease uninsurance among the unemployed before the pandemic struck.

“Our findings also indicate that Medicaid coverage will sharply increase as workers become unemployed, particularly in Medicaid expansion states,” the Urban Institute researchers stated. “However, given that jobless rates may reach unprecedented heights under the COVID-19 pandemic, steep increases in Medicaid coverage will strain state budgets, restricting already limited resources in the very communities hardest hit by the pandemic.”