During Thursday's hearing of the Pennsylvania Senate’s Appropriations Committee, the topic of tying work requirements to public benefits became a frequent point of contention between Republican senators on the committee and the head of the state’s Human Services Department.
Human Services Secretary Teresa Miller was appearing before the committee as part of its budget review process, alongside Secretary of Health Dr. Rachel Levine. During the wide-ranging, three-hour hearing, a number of senators wanted Miller to explain the rationale behind Democratic Gov. Tom Wolf’s veto last year of a bill that would’ve introduced work requirements for Medicaid recipients.
Sen. Lisa Baker, R-Dallas, asked Miller to expound on her previous assertions that introducing a work requirement would cost the state hundreds of millions of dollars.
“I think from the governor’s perspective … the bigger concern with implementing a work requirement is that ultimately we’re talking about penalizing people and taking away their access to healthcare,” Miller said. “But in terms of the fiscal impact … we think the cost would be somewhere between $600 [million] and $800 million in the first year.”
Asked by Baker to elaborate, Miller said that with employment and training programs and child care costs, the state would need to hire “a couple hundred” additional staff to oversee compliance. She indicated that the calculations of the employment, training and child care costs were based on “federal guidance” rather than anything specifically in law that would require that those measures be implemented.
“I think the federal government, for states that want to move in this direction, they want to make it clear that states are expected to provide those same supports,” Miller said.
She said that while other programs that carry work requirements have those provisions funded by federal dollars, Medicaid would not do so.
“Medicaid … has made it clear that Medicaid won’t cover those costs,” Miller said. “So those are costs that would be borne by the state if we chose to move in this direction.
Sen. David Argall, R-Mahanoy City, wanted to know if Miller and the Wolf administration would support a more modest requirement tied to Medicaid benefits.
“Would you support a more limited requirement that able-bodied Medicaid recipients return to school, get their GED or get their high school diploma if perhaps they don’t have it, or if they do, require some kind of job training in a field that currently requires a fair number of new workers?” Argall asked.
Miller’s response suggested that the administration was loathe to introduce any kind of provision that would lead to people losing benefits.
“If we’re talking about doing things to address barriers people face to get them to work, I think there’s all the room in the world for us to work together to make that happen,” she said. “If we start talking about penalizing people and taking away their access to healthcare, I don’t think that helps get them to work.”
Argall asked if Miller was concerned by the fact that Pennsylvania has 486,000 people claiming Medicaid benefits while neither disabled nor elderly. Miller replied that many of that number might not actually be able-bodied for a variety of reasons, and without better information she was concerned about sweeping responses to try to address the number of able-bodied Medicaid recipients.
To that point, Sen. Scott Martin, R-Lancaster, suggested that implementing a work requirement would solve the problem of lack of information, because anyone incorrectly labeled as able-bodied would quickly identify themselves as such.
“The information is coming to you, because there’s something on the line,” he said. “It either forces people to work or to [explain otherwise].”
Under questioning from Sen. Scott Wagner, R-York, Miller also rejected the idea of work requirements for SNAP benefits, also known as food stamps.
“I would argue that we want everyone that can possibly be on SNAP to be on SNAP,” she said. “It’s a 100 percent federally funded benefit, and we know that individuals who are on SNAP have better health outcomes and spend less in terms of health care dollars.”
Wagner seemed taken aback at the idea that getting people off SNAP would be a bad policy.
“I’m really struggling with, you want to increase the SNAP [enrollment],” he said. “I’m trying to be sensitive, but I’m trying to connect the dots. Obviously, my number one agenda item would be to have people gainfully employed and have better improving lives.”
An analysis by the Commonwealth Foundation, a nonprofit group that encourages free market solutions to enhance the state’s economy, described Miller’s remarks on SNAP as “shocking.”
“Work, not enrollment in food stamps, Medicaid or any other program is the ultimate pathway out of poverty,” the analysis by the Commonwealth Foundation’s Elizabeth Stelle said. “With a worsening manufacturing and construction labor shortage, it’s nonsensical that the vast majority of healthy adult Pennsylvanians using food stamps are exempt from work or volunteer requirements.”