Pennsylvania lawmakers, government officials and advocates on both sides of the aisle came together in Harrisburg on Wednesday in hopes of finding middle ground on an issue that’s being discussed in statehouses across the country.
The Senate Majority Policy Committee, along with members of the Senate Health and Human Services Committee, held an informal hearing to discuss whether the state should implement a work requirement for Medicaid recipients.
While participants said they found common ground in that they want to help those on public assistance get off those programs, the disagreement came on whether mandatory work initiatives are the way to go.
Work requirement initiatives focus on the able-bodied Medicaid recipients, and under Centers for Medicare and Medicaid Services guidelines, direct eligible beneficiaries to find work, job training or volunteer in order to continue receiving benefits.
Indiana and New Hampshire have implemented work requirement programs, while a federal judge has blocked Kentucky from starting one and Arkansas from continuing its program. However, that has not kept other states from seeking CMS approval for their initiatives.
State Sen. Art Haywood, D-Abington, noted that Catholic bishops in Ohio have opposed that state’s plan because they see access to health care as a moral issue. In addition, many of the jobs that Medicaid recipients find are minimum wage jobs, which he said will not pay enough to make them self-sustainable.
Nicholas Horton, a research director for the Foundation for Government Accountability, said before the judge’s order, 14,000 Arkansas residents left Medicaid because their income grew. Over a full year, that would have saved the state about $300 million, he said.
Pennsylvania Secretary of Human Services Teresa Miller said the state currently has work requirements with its Temporary Assistance for Needy Assistance and Supplemental Nutrition Assistance Program. However, about half of those who leave the program after getting work end up back on it within a year because they’ve lost their job.
In many cases, Miller’s staff learned that workers lost their job because of child care or other issues that kept them from going to work. She said CMS requires states to help people with child care and transportation needs, but that cannot come out of Medicaid funding.
In addition, some jobs require workers to work early or late hours that may keep them from getting the help they need in order to keep their job.
“A work requirement doesn’t help individuals address these barriers,” she said. “Instead, it simply creates an additional barrier. People need to have access to health care if they’re going to be successful in the workforce.”
State Sen. Scott Martin, R-Lancaster, said, though, that families across the state that are not receiving public assistance face many of the same issues on a daily basis.
“Is it wrong to have an expectation or a motivator to get people to follow that same pathway that every single day we all wake up to do?” he asked.
A work requirement for Pennsylvania Medicaid would likely affect about 90,000 individuals, Miller said. However, the state would have to set up staffing to investigate about 800,000 people to determine if they qualify for an exemption or must find work.
Most of those 90,000 are in the Medicaid expansion category, which takes up about 3 percent of the program’s budget. The aging and disabled populations, which combine for 30 percent of the population, make up 80 percent of the spending.
State Sen. David Argall, R-Schuylkill/Berks, told Miller that he and Martin plan to file a work requirement bill in the near future. While he noted that she and other Wolf Administration officials will likely oppose the bill, the policy committee chairman still asked for her help in finding a solution to transition those who can work off Medicaid.
“Get us something that will encourage work for those people who can do it, and then we can afford to do more for our parents and the disabled,” he said.