ODM Releases Medicaid Work Requirement Waiver Proposal

Per legislative mandate in HB 33, the Ohio Department of Medicaid sought feedback from interested parties on a Medicaid Work Requirement proposal. Please see ODM’s notice, background information, and draft waiver application. Accordingly, the Ohio Council submitted comments regarding these proposed changes, which are linked here. We will continue to track any changes or updates to these proposed changes and will keep Ohio Council members informed, accordingly.

The proposed policy would implement changes in the 1115 Demonstration Waiver Application to impose work requirements, with exemptions, on Ohio Medicaid’s Group 8 eligibility population.  The proposed Medicaid work requirements closely follow the legislative mandate and create exceptions for those participating in substance use disorder treatment or have a serious mental illness.  Even with that ODM anticipates about  61,000 Ohioans enrolled under Group 8 could potentially lose their health insurance.  As a reminder, toward the end of the first Trump administration, CMS approved a similar work requirement waiver that was not implemented due to the Biden administration halting all federally approved work requirement waivers.  It is anticipated the Trump administration will allows Ohio Republican state leaders to proceed with their plan and Medicaid work requirements are being more widely considered.