The Medicaid 1115 waiver program allows states to apply for and receive permission from the Center for Medicare and Medicaid Services (CMS) to waive certain federal guidelines for Medicaid. Almost every state has a 1115 waiver for something. They are most commonly known as the alternative pathway for Medicaid Expansion for Red states.
CMS just released a letter last night indicating that it has new guidance and new desired boundaries for 1115 waivers that it will now approve. CMS is looking for more punitive waiver applications as well as indicating that it is willing to take Indiana HIP 2.0 HSA based Medicaid expansion to a national scale.
Deprioritizing etc — Really — your administration wants to cut $880 billion from Medicaid over a decade for upper income tax cuts so please cut the sanctimony.
Here is the work requirement.
The Obama Administration would not tie Medicaid to work requirements. Medicaid is a medical program. There are other work search and job training programs that are optimized as such.
This is a combination of splitting the poor into the deserving and non-deserving as well as an introduction of friction to decrease enrollment. Most people on expansion are either working, looking for work, in school or a primary care giver for dependents with significant needs. There are very few lazy lay-abouts. Instead these requirements create more hurdles that people have to jump, more hoops they have to shimmy through and more opportunities for their paperwork to be messed up. It aligns with the ritualistic humiliation of drug testing requirements for unemployment and TANF benefits. It is an assertion of power.