Wolf, Republicans resume tug-of-war over Medicaid work requirements

Two Republican state senators are resuscitating a plan to require many able-bodied Medicaid recipients to prove they’re working, volunteering, or looking for jobs to qualify for healthcare coverage.

Democratic Governor Tom Wolf has already vetoed two similar bills.

GOP Senator Scott Martin of Lancaster County, one of the measure’s two sponsors, said this time around he and Senator David Argall of Schuylkill County have tweaked things to appease Democrats.

They added a few new ways for people to be exempt — like being designated “medically frail.”

The requirement itself is more flexible, too. A person could qualify for Medicaid by volunteering or going to college, along with working or looking for jobs. They’d be able to mix and match to reach the necessary hours.

Martin and other Republicans who are bullish on work requirements say they’re a way to keep Medicaid spending in check.

“This program, last year, grew by over one billion dollars,” Martin said. “If it keeps growing at the pace it’s growing, the program is not going to be sustainable.”

According to the Kaiser Family Foundation, Pennsylvania has been ranked fourth in the nation for overall Medicaid spending. In the 2017 fiscal year—the most recent one tracked by the foundation—the commonwealth put more than $28 billion toward Medicaid.

Citing Department of Human Services data, Martin noted 495,719 non-disabled state residents between the ages of 19 and 64—the group that was able to get Medicaid under the Affordable Care Act—report no income.

“We owe it to the taxpayers in this commonwealth. We owe it to the people who truly need this program,” Martin said. “For its sustainability, we have to put [work requirements] in place.”

Ali Fogarty, a spokeswoman for DHS, disputed the senators’ conclusion that requiring work will slow rising costs.

Most of commonwealth’s Medicaid dollars, she said, go to seniors and disabled people, who wouldn’t be subject to work requirements anyway. Though they make up about 29 percent of the population receiving Medicaid in Pennsylvania, they have driven 69 percent of total costs this fiscal year.

“Work requirements do nothing more than create an administrative burden that costs the commonwealth money to implement and operate and prevents low-income people from accessing the health care they need to stay healthy and succeed in the workforce,” Fogarty said in a statement.

She said the department is still reviewing the bill, but generally opposes legislation it deems likely to reduce access to healthcare.

Fogarty added, DHS is “not opposed to work” but would rather put money toward voluntary employment and job-training programs.

J.J. Abbott, a spokesman for Governor Tom Wolf, also decried the bill, saying Wolf’s position hasn’t changed.

“In other states, these requirements are resulting in less people having access to health care and are not helping improve health outcomes, which is the purpose of the Medicaid program,” he said.

As an alternative to work requirements, Abbott pointed to a plan the governor announced in January, aimed at redesigning existing job training programs to boost participation.

Martin and Argall’s bill is already assigned to the Senate’s Health and Human Services Committee.

Martin said he expects it will be considered by the GOP-controlled chambers soon after session resumes later this month.

In order to create Medicaid work requirements, states have to apply to the federal government—a process enabled by the Trump administration last year.

Sixteen states have so far applied, and nine have been approved.