Submitted by the Washington State Health Care Authority

During the week of Jan. 9, the federal government signaled its intent to allow states to establish work requirements for Medicaid clients. This is the first time since the Medicaid program launched in the 1960s that employment criteria would be tied to Medicaid other than through pre-approved state waivers.

In Washington, more than half of Apple Health (Medicaid) clients ages 18 to 64 who do not have a disability are already employed. According to a recent study by the Henry J. Kaiser Family Foundation, 62 percent of households with adults enrolled in Medicaid in Washington have at least one full-time worker in the family.

HCA and Gov. Jay Inslee’s office are not exploring adding work requirements to the state Medicaid program.

“Our focus in Washington’s Medicaid program is promoting the health and well-being of our state residents and communities, and the majority of Apple Health clients do work,” said HCA Director Sue Birch. “We do not want to pursue a strategy that could take away health care from people. What we are doing is providing targeted supports that will help qualified Apple Health clients to maintain housing and jobs — and ultimately self-sufficiency.”

Through a federally approved Medicaid waiver, Washington is preparing to launch new services for qualifying Apple Health (Medicaid) clients that includes supported employment services to help people with physical, behavioral or long-term service needs that make it difficult for them to get and keep a job.

This benefit will provide individualized job coaching and training, employer relations, and help with job placement. These services have proven especially effective for individuals:

– With disabling conditions struggling to remain engaged in the labor market

– Experiencing significant mental illness, substance use disorder, or co-occurring conditions

– Who need long-term care for complex needs

– Are vulnerable youth and young adults

Apple Health clients must complete a needs assessment to access these services.

Through the same waiver, Washington also is launching innovative supportive housing services to help individuals get and keep housing (the funding will not be used to pay rent), and additional support to family caregivers to help people stay at home and delay or avoid the need for more intensive care.