Utah News Dispatch
‘I have a hard enough time’: Utahns urge state not to impose work requirements on Medicaid
Utah state officials are looking to submit a waiver to federal officials to re-impose work requirements on some recipients of Utah’s Medicaid expansion population.(Stock photo by zimmytws/Getty Images)
Even though Michael McCoy doesn’t have a home, he was one of about a dozen people who showed up in person to a public hearing on Friday to urge Utah leaders against imposing work requirements on thousands of the state’s Medicaid recipients.
McCoy, 37 — who has been staying off the streets by sleeping in a blue bus offered by the Nomad Alliance, a nonprofit that helps unsheltered Utahns — said he was recently diagnosed with a lung disease called idiopathic pulmonary fibrosis. He’s been told that he has maybe five to 10 years left to live, “and there’s no cure for it,” he said, so all he can do is focus on medical treatment that helps him stay comfortable through the remainder of his life.
“If I were to lose my Medicaid, pardon my language, but there’s no way in hell I’d be able to afford any of that,” he said. “I’ve been on the streets my entire adult life. … I have a hard enough time trying to feed myself.”
Friday’s public hearing at the Multi-Agency State Office Building in Salt Lake City was the first of two scheduled as part of a 30-day public comment period the state officials are required to hold before submitting a proposed waiver to the federal Centers for Medicare and Medicaid Services (CMS), in June.
Advocates sound alarm as Utah looks to impose work requirements on Medicaid expansion
That waiver, as currently drafted, would ask President Donald Trump’s administration to allow Utah to reinstate work requirements on the state’s Medicaid expansion program. Currently, about 75,000 adult Utahns are enrolled in the state’s expansion program, which allows Medicaid eligibility to Utahns whose annual income is up to 133% of the federal poverty level (roughly $20,800 for an individual or $42,760 for a family of four, according to national thresholds).
The waiver would permit a list of exemptions to the work requirement, excluding those working at least 30 hours a week, those who are 60 or older, pregnant, physically or mentally unable to meet the requirements, parents with a child dependent under the age of 6, among others. And it would allow Medicaid recipients to claim “good cause” for circumstances not on the exemptions list, such as hospitalization or a death in the family, according to state officials.
However, of those 75,000 adults enrolled, an estimated 7,900 would not fall under an exemption and would be subject to work requirements if the state submits the waiver and it’s approved by federal officials. That means those 7,900 could lose their Medicaid coverage if they don’t start working or submit documentation to the state that they’re applying for at least 48 jobs during a three-month period.
Along with McCoy, concerned Utahns and low-income advocates came to Friday’s public hearing to express concerns about the Utah Department of Health and Human Services’s decision to re-submit the Medicaid work requirement waiver.
Previously, when the state’s first waiver was submitted in 2020, the work requirement was approved at the time under Trump’s first administration, but just months later it was suspended amid the COVID-19 pandemic. Then, in 2021, when Utah’s waiver was up for renewal, former President Joe Biden’s administration required the state to remove that work requirement.
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Now, with Trump back in the Oval Office, Utah DHHS agency leaders have decided to resubmit it. The move adds Utah to the list of states looking to impose work requirements on certain Medicaid recipients under a Republican-controlled Congress and Trump, wanting to encourage people to find work and reduce their reliance on public assistance.
However, several low-income advocates told state officials during Friday’s hearing that mandating work requirements on vulnerable populations — especially those who are medically frail or experiencing homelessness — would at best saddle them with unnecessary paperwork they don’t have time for and at worst cause them to lose their medical care.
Kseniya Kniazeva, founder and president of Nomad Alliance, said many of the homeless Utahns her nonprofit helps rely on Medicaid coverage.
“Without Medicaid, they would suffer,” she said, worrying that imposing work requirements would mean the difference between life and death for many of Utah’s homeless.
“The population that I serve cannot work 30 hours a week while they’re on the streets,” she said. “If they could, they would get a job and they would get health care through their job. That’s why Medicaid is here, it’s for people who cannot work because they have chronic health conditions or mental health conditions.”
Kniazeva said for many Utahns experiencing homelessness, almost all of their energy is spent on dealing with keeping a roof over their head and staying safe and healthy — not looking for a job or jumping through administrative hoops to keep health care coverage.
“We cannot remove crucial health care for this population,” she said. “Forcing them to apply to 48 jobs in a three-month period? … When their whole entire life is consumed by trying to find food and water and a bathroom today, how are you supposed to think about applying for jobs so you can keep your medical care?”
Most of them don’t even have phones, she said, let alone access to a computer.
“For the love of God, please,” Kniazeva said. “This is not what Jesus would do.”
Stephanie Burdick, consumer representative on the state’s Medical Care Advisory Committee, said even though the state’s proposed waiver includes a list of exemptions, still requiring Utahns to prove they qualify for an exemption creates too many administrative obstacles for vulnerable populations.
“This mass surveillance of poor people and mass surveillance of sick people, it infringes on basic American rights,” Burdick said, her voice straining with emotion. “Why should they have to prove to you that their health conditions meet your definition (of qualifying for a work requirement exemption)?”
Burdick questioned why the Utah DHHS is moving forward with re-submitting the waiver when it has not received a new mandate from state legislators to do so. If state leaders really want to increase employment for Utahns, she said they should focus on voluntary job programs, not make health care coverage contingent.
“Do not force this kind of government bureaucracy on Utahns’ health care,” she said.
Jennifer Strohecker, the state’s Medicaid director, repeatedly thanked those who attended Friday’s meeting and said their input would help inform the final version of the state’s waiver application.
“These enrich our process and allow us to really consider multiple angles when evaluating this policy proposal,” she said.
Friday wasn’t the only opportunity for Utahns to weigh in to the proposed waiver. There’s another public hearing scheduled for May 14 at 4 p.m.. at the Multi-Agency State Office Building, located at 195 N. 1950 West in Salt Lake City. Utahns can also submit comments on the state’s website or email them to Medicaid1115waiver@utah.gov.
