In a previous blog, we reviewed pending and approved 1115 waivers in 11 states. These reviews provide an overview of 1115 waiver applications, including a focus on work requirements, lock-outs, changes in coverage structures, repealing the Medicaid IMD exclusion, and other behavioral health initiatives.  

On April 30, 2018, Ohio became the latest state to submit an 1115 waiver to include work requirements for certain Medicaid beneficiaries. The waiver application requires individuals in the Group VIII category – those with income level of 0-138% of the federal poverty level (FPL) – to meet the Work and Community Engagement requirement to maintain their Medicaid eligibility. These requirements will closely mirror existing SNAP and Able-Bodied Adults without Dependents (ABAWD) requirements. There are at least fifteen exemptions to the work requirements outlined in the 1115 waiver request.

If the individual is not exempt, they will need to work or participate in a community engagement activity for a minimum of 20 hours per week, or 80 hours averaged monthly. These activities include education and training activities, job search or readiness programs, or the Work Experience Program, which supports beneficiaries in meeting work activity requirements through private or government entities.

Lastly, Ohio is requesting a federal match for supportive services such as transportation to help eligible beneficiaries in meeting the work and community engagement goals. If there is no federal match, the State would consider granting beneficiaries a good cause exemption. To date, Ohio is the only state with a submitted 1115 waiver including work requirements that is pursuing federal match for supportive services to help beneficiaries meet the work requirement.