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Comments: Alabama Medicaid Workforce Initiative

The Medicaid program, now in its 53rd year, is a success story. Through Medicaid, millions of low-income Americans have built well-being and gained greater economic security via access to health insurance coverage. This coverage has guaranteed health care to those who are unable to find work, whose employers or job types do not grant access to health insurance, or who are caregivers, students, or who have disabling conditions that interfere with regular work.

As an organization that focuses on the health coverage and well-being of older Americans and people with disabilities, we have a particular interest in how this waiver would harm Alabamans from ages 50 to 60 and Alabamans with functional limitations and chronic conditions of all ages who are not administratively classified as “disabled.”

Alabama’s proposal contains all the core flaws of the work requirements approach as seen in other states. In the recent Stewart v. Azar decision (Civil Action No. 18-152 (JEB), 2 (D.D.C. Apr. 10, 2018) rejecting federal approval of Kentucky’s work requirements waiver, the judge stated that the administration “never adequately considered whether Kentucky HEALTH would, in fact, help the state furnish medical assistance to its citizens, a central objective of Medicaid,” with medical assistance (the statutory term for Medicaid) defined as “payment of part or all of the cost of medical care and services.”

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