On January 11, 2018, the Centers for Medicare and Medicaid Services (CMS) issued a letter to Medicaid directors describing its support of work requirements. CMS cited a connection between health and income as reason to test whether work requirements will “achieve improved health, well-being, and independence.” The administration also provided guidance to states as they develop waiver applications.
Many states, including Missouri, have increasingly viewed work and community engagement requirements as a mechanism to reduce reliance on Medicaid and other social service programs. Evidence from current safety net work requirements suggest that program design is critical to the outcome of such mandates.