Editorial: Stop posturing about Medicaid work requirements

By The Editorial Advisory Board


Last week, a Kentucky court blocked the state’s proposal to impose Medicaid work requirements, citing they “never adequately considered whether Kentucky HEALTH (the state’s Medicaid program) would in fact help the state furnish medical assistance to its citizens, a central objective of Medicaid.”


Yet Gov. Colyer, who was stripped by the Legislature this past session of the ability to implement work requirements without legislative approval, still stands in favor of pursuing work requirements in Kansas even though it will lead to another expensive legal battle the state isn’t likely to win.


It’s another example of shortsighted policy-making that satisfies political talking points but fails to meet the needs of Kansans and ends up costing the state more in a multitude of ways.


First, let’s consider the population Medicaid currently serves. It only covers the most vulnerable who have few, if any, assets, including children, pregnant women, parents of eligible children, people with disabilities and elderly needing nursing home care. Take out the children, the elderly in nursing homes and those with disabilities that prevent work, and it’s largely pregnant women and the parents of sick children who would be subject to work requirements. Countless studies show that most of these people are already working or are caretakers for their sick child.


Under a work requirement system, they’d have to prove they’re working or prove they’re exempt from work requirements, which means Kansas would have to establish a system to verify the employment of the more than 200,000 adult Medicaid recipients. This would be done on the state’s dime as the federal government provides no funding for work requirement programs.


Research shows that programs to verify whose working and who doesn’t have to work are not only costly to states to administer, but they don’t increase employment. “Work requirements in Medicaid will result in many people losing coverage, in most cases simply because of the red tape and bureaucratic reporting requirements, and relatively few for not meeting the requirement to work,” wrote Suzanne Wikle in her policy brief in April for the Center for Law and Social Policy. “In fact, the Congressional Budget Office said in its score of the “Graham-Cassidy” bill that some states would use work requirements to reduce enrollment and the associated costs.”


We’re discouraged Gov. Colyer’s solution to the health care needs of vulnerable Kansans is to further limit access to it. Instead of implementing work requirements that lead to the loss of coverage for sick people, Colyer should follow the lead of states like Montana whose Health and Economic Livelihood Partnership Link (HELP-Link) targets Medicaid enrollees who are looking for work or better jobs and connects them to services such as career counseling, on-the-job training programs, and subsidized employment.
If the governor were really serious about improving health care outcomes and the ability for men and women to share the dignity of work, he would sign a Medicaid expansion bill that would extend health care coverage to the 150,000 waitresses, truck drivers, certified nurses aides, and others who are working low-wage jobs but don’t qualify for Medicaid and can’t afford health care through the marketplace.


Healthy Kansans lead to a stronger workforce and more productive society. Rather than present more barriers, it’s time to stop the political posturing around work requirements and adopt the successful policies implemented in other states that have led to desired health outcomes.