Following Indiana and Kentucky’s lead, Missouri looks at Medicaid work requirements

Calling Medicaid “the most unrecognized policy crisis in the country,” Sen. David Sater, R-Cassville, discussed in a committee hearing Wednesday a bill he introduced that would add work requirements to Medicaid eligibility.

The bill requires “able-bodied” Medicaid recipients to work a minimum of 80 hours a month through paid employment as well as volunteer work, job training, job searching, attending school or caring for the elderly or disabled.

At the beginning of the year, the Trump administration gave a green light to state governments that want to modify Medicaid eligibility. Missouri would need to apply for a waiver from the federal Centers for Medicare and Medicaid Services (CMS) to make the change.

Sater’s bill exempts Medicaid beneficiaries with disabilities, substance abuse disorders or complex medical conditions. The bill would not affect pregnant women, primary caregivers or low-income Missourians living in areas with high unemployment or limited economic opportunity.

“It’s obvious that the status quo is not working,” Sater said. “We need to bring this program more in tune with the needs and philosophies of Missourians.”

Sater cited the example of Kentucky, the first state to implement work requirements to Medicaid in January. And in early February, CMS approved a similar plan in Indiana.

Sydney Watson, a law professor at St. Louis University, testified against the bill, mentioning lawsuits already have been filed against Kentucky’s waiver.

She expressed concern the bill would deny low-income Missourians health-care services because of red tape.

“Every parent who qualifies for Medicaid is going to have to prove how they are working, whether they are working, whether they are ill, whether they are taking care of a child,” Watson said. “My concern is that people will lose eligibility because the paperwork will get lost.”

If the bill passes, it joins a 2015 Senate bill that added work requirements to the the state’s Temporary Assistance for Needy Families program.

Sater’s bill follows the conservative vision outlined in a similar House bill heard last week that would add work requirements to Supplemental Nutrition Assistance Program (SNAP) recipients.

“At the end of the day, this bill is about introducing personal responsibility,” Sater said.

James Harris, a lobbyist for the Opportunity Solutions Project based in Naples, Florida, spoke in favor of the bill and said work requirements for programs such as Medicaid and SNAP help families rise out of poverty.

In Wednesday’s Senate hearing, Sater claimed that, according to the U.S. Census Bureau, most able-bodied adults on Medicaid in the state do not work at all.

Sen. Jill Schupp, D-St. Louis County, asked Sater if he really believed families maintain their annual income at $6,000 to access Missouri’s health-care system.

“I’m really concerned that we are putting people’s health in additional jeopardy,” Schupp said.

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