A bill that would require Minnesota Medical Assistance (MA) recipients to work, take part in job training or perform community service is advancing in the state legislature, even as critics warn that the concept may be costly and unworkable.
House File 3722, authored by Rep. Kelly Fenton, R-Woodbury, is now in the House Ways and Means Committee. Fenton is hopeful about the bill’s chances of passage in the legislature, which is controlled by Republicans.
“Currently, in the state of Minnesota we have more jobs available than job seekers,” she told Watchdog.org. “So it is our hope to give able-bodied, childless adults a hand up to move into jobs that help them gain skills and move into even better-paying jobs and thus be able to make a lot more money and gain access to health care that they choose.”
The legislation would require additional steps for certain able-bodied adults to qualify for benefits under the state’s Medical Assistance program, which is known as Medicaid in other states. Under the provisions of the bill, recipients would be required to work, attend a job-training program or do community service for 80 hours per month, according to Fenton.
MA spending has been growing unchecked for years even as the state’s economy has been improving, she said. Her bill will help to control that spending and protect the MA program for those who need it most, Fenton said.
“Wages are rising, and unemployment is falling …” she said. MA spending "will start to crowd out other areas of our budget.”
Fenton doesn’t see the state needing to invest additional money in job-training programs or more public employees to administer the new requirements. County workers have adjusted to work requirements placed on those in the federal Supplemental Nutrition Assistance Program (SNAP), and the same should happen if work requirements are added to the MA program, she said.
“We already have countless job-training programs in Minnesota,” Fenton said, adding that many construction companies desperately need workers and have said they will train them themselves.
HF 3722 is also not a heavy-handed regulation, she said. MA recipients who are also abiding by the SNAP work mandates will be exempt from additional requirements, Fenton said.
Lynn Blewett, a health policy and management professor at the University of Minnesota, acknowledges that the goal of getting people steady employment and making them more self-reliant is good, but the MA program is not the vehicle to accomplish that.
“The concerns that I have and that others have raised is that Medicaid is a medical program,” Blewett told Watchdog.org. “It’s not a work-placement program.”
If a work requirement is imposed, Blewett and others are concerned that the state could lose tens of millions in federal funds annually. That’s because under the Medicaid expansion program to provide health care coverage through Obamacare, the federal government pays for 90 percent of the costs. If a lot of those people drop out, federal funds now flowing to Minnesota would be reduced, critics say.
“If you have a work requirement without the assistance in trying to find people work, I think it’s likely that … a lot of people will lose coverage,” Blewett said.
In addition, about 60 percent of Medicaid recipients nationwide already work – 42 percent full-time and 18 percent part-time, she said. The percentages are likely similar in Minnesota’s MA program, according to Blewett.
The state would also have to spend more money to ensure recipients are abiding by the work requirement, she said.
“They would have to have a monitoring system to verify that they’re working every month …” Blewett said. “That’s one of the concerns. There will be an administrative cost to administering the program.”
Jason Flohrs, state director of Americans for Prosperity – Minnesota, said his organization supports the concept of work requirements for MA recipients. But any new requirements should focus on improving people’s lives, not simply trying to help the state balance its books, according to Flohrs.
“I don’t want to cut people off of the program to save money,” he told Watchdog.org. “It’s to give them an incentive to re-engage.”
A work requirement could help recipients keep their health care, find professional success and contribute to Minnesota’s economy, Flohrs said. And as people work their way into better-paying jobs, they may be able to better support themselves, leaving more resources for the truly needy, including the elderly, disabled, pregnant women and others, he said.
“Medicaid is the largest single item in our budget …” Flohrs said. “We have a very large and explosive growth in terms of our budget, to the point that we’re starting to worry about sustainability in the long term for people who need the (MA) program the most.”
Federal reimbursement concerns, along with recipients’ mental health or disability issues, should be resolved in negotiations and should not become barriers to improve the program, he said.
Opportunities for people to find meaningful employment are plentiful, according to Flohrs, who noted that there are more job openings in Minnesota than workers to fill them, along with many types of skills-training programs.
“Add all that up and if you want to work in Minnesota, you can find a way,” he said.