And it's not about promoting financial independence - we have yet to see a plan for creating better paying jobs that offer benefits.
Bevin noted in a news conference Friday that Kentucky's is the first waiver with a community engagement requirement approved.
Bevin unveiled the demonstration waiver known as Kentucky HEALTH June 22, 2016.
Bevin said the waiver will be "transformational".
The acronym HEALTH stands for "Helping to Engage and Achieve Long Term Health".
Bevin expects the changes to save the state more than $300 million over the next five years. Verma and other Republicans said implementing work and community engagement requirements could help improve health outcomes by connecting people with jobs and training.
"It will indeed become the model for the nation - mark my words", Bevin said Friday. Kevin de León, a Democrat and the leader of California's Senate, wouldn't comment on the proposal because he said it's a non-starter.
Bevin has said that the system can not continue as it has because it costs too much, ignores private market dynamics and fails to prepare Kentuckians for self-sufficiency. "They want to develop programs that will help them break the chains of poverty and live up to their fullest potential".
"Medicaid is a health care program", he said.
Kaiser Health News (KHN) is a national health policy news service. The current request would require able-bodied adults without dependents to work at least 20 hours a week. Of that number, about 25 percent would lose coverage because they don't comply with the work requirement.
Republicans have long wanted to add work requirements to the Medicaid program, which covers almost 75 million low-income children, adults, elderly and disabled Americans. The letter released Thursday by CMS contains similar language on the work requirements. It continually refused, arguing that the policy goes against the goals of the program, which are to give more people access to health insurance. That Medicaid expansion was sharply criticized by conservatives, and Republicans in Congress tried to add work requirements in their unsuccessful bid previous year to overturn the health law.
Emily Beauregard, executive director for Kentucky Voices for Health, an advocacy group, said one of the key exemption issues states must work out is defining who is "medically frail"- a designation that CMS said would exempt enrollees from the requirement. The program allows beneficiaries to be locked out of benefits if they fail to produce proof they are following the rules, but they can get back in the system once they meet requirements for 30 days.
"We owe beneficiaries more than a #Medicaid card", tweeted CMS Administrator Seema Verma Thursday. And when someone gets sick, the last thing she needs to worry about is whether she'll also lose her health coverage for not working. The work requirements will likely be challenged in court.
Studies have shown that access to Medicaid makes it easier for people to look for work and maintain employment.
"They're going to try to force a square peg into a round hole", he said.
The state will still have to apply for a waiver and undergo the full federal review process, but CMS will now support state efforts to "test incentives that make participation in work or other community engagement a requirement for continued Medicaid edibility", according to the January 11 letter. It is the first state to win such approval. Providers and advocates in Kentucky immediately blasted the waiver approval. The Center for Children and Families at Georgetown University, citing the state's own projections, said the waiver provision could disqualify almost 100,00 Kentuckiansfrom Medicaid in the next five years. Imposing a work requirement as a condition for people to receive public health insurance support could be the sparks that lights a fire and gets someone to decide to make those changes.