Organizations Join to Oppose Medicaid Work Requirements

160 National, State and Local Organizations Join to Oppose Medicaid Work Requirements
Leading Health Care, Civil Rights, Criminal Justice, Faith-Based, Housing and Disability Rights Advocates Say New CMS Policy Will Harm Individuals and Communities Impacted by the Opioid Crisis and Mass Incarceration

Nearly 1 in 3 adults have a criminal record that poses a barrier to finding employment
3 out of 10 people living with opioid use disorder rely on Medicaid 

February 15, 2018: 160 organizations, representing leading health care, disability rights, criminal justice, faith-based, housing and civil rights groups, today jointly announced their opposition to the new Centers for Medicare and Medicaid Services (CMS) policy to allow states to impose work requirements on Medicaid recipients.

In the letter to recently confirmed Health and Human Services (HHS) Secretary Alex Azar, the 160 organizational signatories outline how the policy will have a significant and disproportionately harmful impact on individuals with chronic health conditions, especially those struggling with substance use disorders (SUDs) and mental health disorders, as well as those with conviction and arrest records.

Gabrielle de la Guéronnière, Director of Policy at the Legal Action Center said, “CMS’s new policy cruelly punishes and stigmatizes low-income people – depriving them of the life-saving care that many need to become and remain healthy.” She adds, “The Administration has stated that stemming the opioid crisis and reforming the criminal justice system are key priorities; this new CMS policy is totally contrary to achieving both of those important goals.”

The letter delineates numerous ways in which the new guidance provides insufficient protections for people with disabling conditions, noting that, “Many individuals may be caught in a bitter catch-22, where they cannot qualify for Medicaid because they do not have documentation of disability, but they cannot get their disability documented because they do not have health coverage.”

The signatories also note that the CMS guidance fails to recognize the stigma, discrimination, and related legal and policy barriers to employment confronting people with criminal records. Over 70 million Americans, or nearly one in three U.S. adults, have an arrest or conviction record. With over 85 percent of employers conducting background checks, it is extremely challenging for people with records to secure employment or even engage in volunteer activities. Imposing work requirements on Medicaid will impair access to vital health care, making it even more difficult for formerly incarcerated people and others with criminal records to successfully reenter the community, and increasing both costs to the corrections system and rates of recidivism.

The statement further warns that by allowing states to make it difficult for Americans to access vital SUD care through Medicaid, CMS will increase the devastating impact of the opioid epidemic nationwide, starting with some of the hardest hit jurisdictions, such as Kentucky.

Speaking to the impact of the policy on people who need substance use disorder care, Grant Smith, Interim Director of National Affairs at the Drug Policy Alliance notes that, “Medicaid currently covers three out of every ten individuals living with opioid use disorder and provides critical access to medication-assisted treatment and other forms of care that help reduce overdose and other forms of drug-related harm. At a time when this country is facing an overdose crisis, we cannot afford to impose more barriers to lifesaving health care.”

Elizabeth Lower-Basch, Director of Income and Work Supports at the Center on Law and Social Policy says, “This policy is cruel and contrary to the purpose of the Medicaid program: taking people’s health care away does not promote health.”  She added, “Most people who have Medicaid and can work, are already working. And when people are not healthy or able to get needed medications, they are less likely to be able to work.”

The groups signing on to the letter to Secretary Azar are:

ADAP Advocacy Association (aaa+); Addiction Policy Forum; Advocacy Center of Louisiana; AIDS United; Alameda County Community Food Bank; American Association on Health and Disability; American Association of People with Disabilities; American Association for the Treatment of Opioid Dependence (AATOD); American Civil Liberties Union; American Federation of State, County & Municipal Employees (AFSCME); American Foundation for Suicide Prevention; American Group Psychotherapy Association; American Psychological Association; American Society of Addiction Medicine; Association for Ambulatory Behavioral Healthcare; Bailey House, Inc.; Board for Certification of Nutrition Specialists; Brooklyn Defender Services; CADA of Northwest Louisiana; California Consortium of Addiction Programs & Professionals; California Hepatitis Alliance; Caring Across Generations; Caring Ambassadors Program; CASES; Center for Civil Justice; Center for Employment Opportunities (CEO); Center for Health Law and Policy Innovation; Center for Law and Social Policy (CLASP); Center for Medicare Advocacy; Center for Public Representation; Charlotte Center for Legal Advocacy; CHOW Project; Coalition of Medication Assisted Treatment Providers and Advocates; Colorado Center on Law and Policy; Community Access National Network (CANN); Community Catalyst; Community Health Councils; Community Legal Services of Philadelphia;   Community Oriented Correctional Health Services; Community Service Society; Connecticut Legal Services; Consumer Health First; C.O.R.E. Medical Clinic, Inc.; Council on Social Work Education; CURE (Citizens United for Rehabilitation of Errants); DC Coalition Against Domestic Violence; Desert AIDS Project; Disability Rights Arkansas; Disability Rights Wisconsin; Drug Policy Alliance; EAC Network (Empower Assist Care); EverThrive Illinois; Facing Addiction with NCADD; Faces & Voices of Recovery; FedCURE; First Focus; Florida Health Justice Project, Inc.; Food & Friends; The Fortune Society; Forward Justice; Friends of Recovery – New York; Futures Without Violence; God’s Love We Deliver; Greater Hartford Legal Aid; Greenburger Center for Social and Criminal Justice; Harm Reduction Coalition; Health Law Advocates; Heartland Alliance; Hep Free Hawaii; Hepatitis C Support Project/HCV Advocate; HIV Medicine Association; Horizon Health Services; Hunger Free America; Illinois Association of Behavioral Health; The Joy Bus; JustLeadershipUSA; Katal Center for Health, Equity, and Justice; The Kennedy Forum; Kentucky Equal Justice Center; Kitchen Angels; Justice in Aging; Justice Consultants, LLC; Lakeshore Foundation; Law Foundation of Silicon Valley; Legal Action Center; The Legal Aid Society; Legal Council for Health Justice; Life Foundation; Live4Lall; Liver Health Connection; Maine Equal Justice Partners; MANNA (Metropolitan Area Neighborhood Nutrition Alliance); Massachusetts Law Reform Institute; McShin Foundation; Mental Health America; Mental Health Association in New York State, Inc. (MHANYS); Michigan Poverty Law Program; Minnesota Recovery Connection; Mississippi Center for Justice; NAACP; The National Alliance to Advance Adolescent Health; National Alliance on Mental Illness; NAMI-NYS; National Alliance of State & Territorial AIDS Directors; National Association of Addiction Treatment Providers; National Association of County Behavioral Health & Developmental Disability Directors; National Association for Rural Mental Health; National Association of Social Workers; National Center for Law and Economic Justice; National Coalition Against Domestic Violence; National Council on Alcoholism and Drug Dependence, Phoenix; National Council for Behavioral Health; National Council of Churches; National Disability Rights Network; National Employment Law Project; National Federation of Families for Children’s Mental Health; National Health Care for the Homeless Council; National Health Law Program; National HIRE Network; National Juvenile Justice Network; National LGBTQ Task Force; National Low Income Housing Coalition; National Organization for Women; The National Viral Hepatitis Roundtable; NC Justice Center; New Haven Legal Assistance Association; New York Association of Alcoholism and Substance Abuse Providers (ASAP); New York Association of Psychiatric Rehabilitation Services; New York Lawyers for the Public Interest; New York State Council for Community Behavioral Healthcare; Open Hands Legal Services; Osborne Association; Outreach Development Corp.; The Partnership for Drug Free Kids; PICO National Network; The Poverello Center, Inc.; Project Inform; Public Justice Center; Root and Rebound; Ryan White Medical Providers Coalition; Safer Foundation; Sargent Shriver National Center on Poverty Law; School Social Work Association of America; Sea Island Action Network, South Carolina; The Sentencing Project; Shatterproof; Society of General Internal Medicine; Southern Center for Human Rights; Southern Poverty Law Center; Students for Sensible Drug Policy; Tennessee Justice Center; Three Square Food Bank; Transitions Clinic Network; Treatment Action Group; Treatment Alternatives for Safe Communities (TASC)—Capital District, Inc.; Treatment Alternatives for Safe Communities (TASC) – Illinois; Treatment Communities of America; Virginia Poverty Law Center; and Western Center on Law & Poverty; New York Association of Psychiatric Rehabilitation Services

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Established in 1973, the Legal Action Center is the only non-profit law and policy organization in the United States whose sole mission is to fight discrimination against people with histories of addiction, HIV/AIDS, or criminal records, and to advocate for sound public policies in these areas.

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