Tuesday, February 20, 2018

Work for It. What Trump’s Tough New Medicaid Rules Mean.

LEXINGTON, Ky. — Every day that Steve Olshewsky can convince himself to get out of bed and face the world is a small victory in his eyes.

After a series of panic attacks forced him out of work in 2009, Olshewsky returned to his hometown to recover with family. He's made great strides since then, thanks to medication and his work at Participation Station, a peer-run outpatient clinic for serious mental illness. There, he sits in on group sessions, teaches tai chi to members, and talks clients through rough days on the clinic phone line.

But Olshewsky, who pays for his prescriptions through Medicaid, could soon have to prove he deserves to keep his coverage under a new set of restrictions on able-bodied Medicaid recipients. The Trump administration approved the rules in January through a waiver program that allows states to experiment with changes to Medicaid. 

"I feel threatened," the 59-year-old Olshewsky said at a meeting with Participation Station members and staff to discuss the changes with NBC News last week. "If I wasn't on Medicaid, I wouldn't be sitting here."

Under the new system, called Kentucky HEALTH, non-elderly adult Medicaid recipients will have to hold a job or perform 80 hours a month of "community engagement" activity like classes and volunteering, pay a monthly premium of $1 to $15, earn their vision and dental treatment through a rewards program, and go through the enrollment process again every year. Those who fail to meet the requirements could lose their coverage or face additional co-pays. 

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