--- title: Kentucky Is First State to Adopt Medicaid Work Requirement description: Kentucky is the first state to adopt the Trump administration's new policy of imposing work requirements as a precondition for Medicaid canonical: https://time.com/5102167/kentucky-medicaid-work-requirement/ author: Alana Abramson article:opinion: false article:content_tier: free article:published_time: 2018-01-13T15:50:59.000Z article:modified_time: 2026-08-04T08:04:06.423Z article:section: Politics og:title: Kentucky Adapts New Medicaid Work Requirement og:description: The first state to do so og:url: https://time.com/5102167/kentucky-medicaid-work-requirement/ og:site_name: TIME og:image: https://static.time.com/v3/assets/bltea6093859af6183b/bltee662c8fc0502997/6988f833929fadcc86bef390/matt-bevin-medicaid-kentucky.jpg?branch=production&width=1200&quality=75&auto=webp&crop=16:9 og:image:width: 2000 og:image:height: 1125 og:image:alt: Medicaid Work Requirement-Kentucky og:type: article twitter:card: summary_large_image twitter:title: Kentucky Adapts New Medicaid Work Requirement twitter:description: The first state to do so twitter:image: https://static.time.com/v3/assets/bltea6093859af6183b/bltee662c8fc0502997/6988f833929fadcc86bef390/matt-bevin-medicaid-kentucky.jpg?branch=production&width=1200&quality=75&auto=webp&crop=16:9 ---  # 'It Will Be Transformational.' 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It explains the politics, personalities and power dynamics behind the headlines, twice a week. #### Where can I get analysis of Washington politics by email? D.C. Brief is TIME's free Washington politics newsletter, available at time.com/newsletters. It is written by a TIME senior correspondent who covers the capital full time. #### Who writes TIME's D.C. Brief? Philip Elliott, a senior correspondent at TIME, writes D.C. Brief. #### Is D.C. Brief free? Yes. D.C. Brief is free at time.com/newsletters. ### Sources * TIME Newsletters: [time.com/newsletters](/c/time-nl-dcbrief-2026q3/newsletters?i=2764daf5-7736-41b8-9f7b-77dabf267416&cr=time-nl-dcbrief-2026q3-v1) ## Video: Year in Review: 5 Top Public Policy Changes [Watch (HLS stream): Year in Review: 5 Top Public Policy Changes](https://cdn.jwplayer.com/manifests/Xl6r1BVO.m3u8) (4:27)  _Published 2017-12-21. A look at the year's policy changes with the largest impact on the American people._  by [Alana Abramson](https://time.com/author/alana-abramson/)  ## Alana Abramson Jan 13, 2018 3:50 PM UTC  Kentucky Gov. Matt Bevin announces federal approval of Kentucky's Medicaid waiver in Frankfort, Ky on Jan. 12, 2018 Kentucky Gov. Matt Bevin announces federal approval of Kentucky's Medicaid waiver in Frankfort, Ky on Jan. 12, 2018 Alex Slitz—Lexington Herald-Leader/AP  by [Alana Abramson](https://time.com/author/alana-abramson/)  ## Alana Abramson Jan 13, 2018 3:50 PM UTC The state of Kentucky has become the first to adopt the Trump administration’s new policy of imposing work requirements as a precondition of receiving Medicaid benefits. Consequently, residents of Kentucky who are on Medicaid and considered healthy enough to work, must now comply with certain requirements to receive the health care provided by the government program. The Trump administration announced on January 11 that states could impose [work requirements on Medicaid recipients](https://www.medicaid.gov/Medicaid-CHIP-Program-Information/By-Topics/Waivers/1115/downloads/ky/ky-health-ca.pdf). One day later, the Center for Medicare and Medicaid Services approved a waiver for Kentucky adopting that new policy for the next five years. Under the program, which officially starts in July, Medicaid beneficiaries between the ages of 19 and 64 who do not meet exemption requirements must complete at least 80 hours per month of “community engagement,” which includes work, school, job skills training, or community service. If they do not complete the requirements, Medicaid eligibility will be suspended. The program exempts several categories of recipients, including pregnant women, those diagnosed as “medically frail,” primary caregivers, and former foster care youth. “It will be transformational,” Kentucky Governor Matt Bevin said in an announcement Friday. “Transformational in all the right ways, in good ways, in powerful ways.” More than 2 million people are on Medicaid in Kentucky, [according to the Kaiser Family Foundation](https://www.kff.org/medicaid/fact-sheet/medicaids-role-in-kentucky/), which is nearly one quarter of the state’s population. Kentucky was among the [33 states](https://www.kff.org/health-reform/slide/current-status-of-the-medicaid-expansion-decision/) to adopt the Medicaid expansion program that is a cornerstone of the Affordable Care Act enacted under the Obama administration, but Bevin has been [seeking to implement](https://www.kff.org/medicaid/fact-sheet/proposed-changes-to-medicaid-expansion-in-kentucky/) these changes since he was elected in 2015. Bevin also defended the program from criticism that it was essentially punishing lower income people, and insisted that the program will only impact those who are physically able to work. The recipients of the program who are unable to comply with the new regulations, he said, will remain unaffected. “This idea that somehow we are punishing people, that this will be a detriment to people I think is a huge huge misunderstanding of what people need,” he said, noting that he himself came from a low-income family. “There is dignity associated with owning the value of something you receive.” ## Transcript President Trump likes to brag about all he's gotten done in his first year of office, in fact he's declared himself the most successful of quote, any President in history. There has never been a ten month President that has accomplished what we have accomplished. [ APPLAUSE ] But the American people Aren't so sure. In a national survey in November, 65 % of respondants said they hadn't seen many accomplishments coming out of the White House so far. [ SOUND ] But the truth is somewhere in the middle. It's true that Trump hasn't exactly succeeded in pushing through big pieces of signature legislation. There's been no TrumpCare, there's been no wall with Mexico, one of his biggest campaign promises, but the Trump Administration has also done all kinds of other stuff. From executive orders, to changes to the regulatory state that will fundamentally change the way a lot of us live, here are 5 top policy changes that you'll notice from your kitchen table. Number one. The tax bill. This is a giant piece of legislation. It's the largest tax cut in the history of our country. It cuts taxes for corporations and the very rich. Believe me. Believe, this is not good for me. But if you're in the middle or lower class. It's a little more Ambiguous. you might get a small tax cut over the next few years but all middle class tax cut end in 2025. Number 2, ObamaCare, well trump and his allies failed Failed to push through a total repeal of Obamacare in Congress. They have been chipping away at it along the edges. For example, Trump scrapped the federal subsidies for health insurance companies. Which were used to lower out of pocket costs for low- income people. He also ordered sweeping changes in the nation's insurance. System, allowing sales of cheaper policies with fewer benefits and fewer protections. That unravels a whole lot of what Obamacare is as a law, and depending on where you live, that means bracing yourself for soaring insurance premiums next year. Number three. Immigration. On the campaign trail, Trump promised a border wall. He hasn't done that, but he has overseen an explosion in deportations. Immigration officials have arrested 25 % more people this year than last year. And in December, the Supreme Court approved the third version of Trump's embattled travel ban. His anti- immigration rhetoric has also just changed the way a lot of us think of America. When Mexico sends its people, they're not sending their best. They're bringing drugs. They're bringing crime. They're rapists. And some, I assume, are good people. According to the FBI, hate crimes in the US rose 10 % between 2014 and 2016. And in late November Trump himself retweeted three videos supposedly showing Muslims committing acts of violence. The videos had been posted by an anti- Islam organization, a hate group in United Kingdom. To drive Islam out of this country forever! Number four. Overtime. Trump's justice department ended an Obama- era expansion of the federal overtime rule. That means that about 4 million americans who currently make low incomes will no longer be eligible for time- and- a- half once they work more than 40 hours a week. Number five. The environment. Under Trump the EPA has dismantled dozens and dozens of Obama- era rules reducing the amount of CO2 in the atmosphere. It's also rescinded a rule designed to protect lakes, ponds and streams. It's reopened the Arctic to drilling. It's cleared the way for Keystone XL Pipeline. It's shrunk national monuments. It's allowed coal mining on public lands. We could go on. The problem with all this stuff, with environmental laws and regulations, is that it's really hard to measure what that means for us right now. They're designed in the long- term interest of the country and the earth. So, get rid of clean air and water rules, and is the sky going to turn black next week? No. But is it going to result in a return to the smog and scummy lakes of the 1970's? Yes, eventually. So, Trump hasn't delivered on every campaign promise but he's definitely had a significant impact on our lives already and it's just year one. 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