Under Trump, states may demand work for Medicaid

Associated Press

WASHINGTON

Work requirements for Medicaid could lead to major changes in the social safety net under President Donald Trump.

It sounds like a simple question: Should adults who are able to work be required to do so to get taxpayer provided health insurance?

The federal-state Medicaid program for low-income and disabled people covers more than 70 million U.S. residents – about 1 in 5 – including an increasing number of working-age adults. In a break from past federal policy, the Health and Human Services department under Secretary Tom Price has already notified governors it stands ready to approve state waivers for “meritorious” programs that encourage work.

Separately, an amendment to the still-stuck House GOP health care bill would allow individual states to require work or training for adults, with exceptions such as pregnant women or parents of a disabled child.

Yet a surprising number of working-age adults with Medicaid are already employed. Nearly 60 percent work either full- or part-time, mainly for employers that don’t offer health insurance, says the nonpartisan Kaiser Family Foundation. Most who are not working report reasons such as illness, caring for a family member or going to school.

Geraldine Stewart, a Medicaid beneficiary from Charlotte, N.C., questioned the impact of a work requirement on older adults. Stewart was incapacitated by painful problems with her feet, now relieved by surgery covered under the program. In her early 60s, she was able to return to part-time work as a home health aide after treatment.

“To do work anywhere, I have to have my feet,” said Stewart. “I really hope that they do not force anyone who has a medical condition to work to have to pay for those services. I don’t think it’s been researched properly.”

The debate over work requirements for safety net programs isn’t new. With Medicaid, it doesn’t break neatly along liberal-conservative lines.

Advocacy groups representing the poor may go to court. “Medicaid is a medical-assistance program,” said Jane Perkins, legal director the National Health Law Program.