overnment, and employers. Non-exempt Medicaid beneficiaries will benefit from having a source of income, health coverage, and other health benefits from being employed if they would not have been otherwise; however, they may face difficulties in logging hours and meeting program requirements that will result in loss of health coverage until they are eligible to re-enroll. The state of Arkansas will benefit from having a more productive population with access to health insurance coverage if the program is successful, but will have significantly more paperwork and must ensure provision of job search materials for Medicaid beneficiaries. Employers can benefit by filling some open positions with non-exempt Medicaid beneficiaries, but will have a larger administrative workload from fact-checking employee hours for the work requirements.
Medicaid covers approximately forty percent of adults with opioid addiction, making demonstration waivers that adequately address opioid addiction a necessity.13 New Mexico’s waiver to treat enrollees with opioid use disorders with federal funding was recently extended for five years.16 In this waiver were authorizations to increase copayments for inappropriate emergency department use or high-cost drug utilization, to increase premiums, to terminate coverage for failure to pay premiums after a three-month period, and to eliminate retroactive coverage for new enrollees. 16 Stakeholders include Medicaid beneficiaries, the state of New Mexico, and Medicaid beneficiaries with opioid or other substance abuse disorders. Medicaid beneficiaries without a substance abuse disorder will lose substantial coverage if unable to consistently pay premiums and spend higher percentages of their total income on copayments if unable to meet new requirements; these stakeholders will only benefit from health coverage if they are able to meet the new requirements. Medicaid beneficiaries with opioid addiction or other substance abuse disorders will be harmed in the same way, but will receive an additional benefit for coverage of treatment of their substance abuse disorder. The state of New Mexico will benefit if beneficiaries are unable to meet the new requirements by controlling costs if coverage is terminated, if premiums and copayments are raised, and if beneficiaries are able to meet the requirements by choosing less costly drugs and by appropriately using emergency departments. In addition, the state of New Mexico will also benefit from a healthier population by treating opioid-dependent beneficiaries in their state. Overall, this waiver favor