Mississippi pushes for Medicaid work requirements

Thousands of Medicaid recipients in Mississippi would be required to work to be eligible for the program if the Trump administration approves a controversial state waiver request that recently opened for public comment.

The proposal is likely to set off a firestorm of criticism from Democrats and health advocates, who argue that work requirements, combined with Mississippi’s strict Medicaid eligibility requirements, will result in thousands of people losing their coverage.

The five-year waiver request from Republican Gov. Phil Bryant seeks to require nondisabled adults, including low-income parents and caretakers, to participate in at least 20 hours per week of “workforce training.”

To be eligible, Medicaid beneficiaries must work, be self-employed, volunteer or be in a drug treatment program, among other approved activities. If people don’t comply, they’ll be kicked off Medicaid.

“Approximately twenty-five percent of Mississippi’s population is enrolled in Medicaid and we believe our proposal to provide workforce training opportunities to those who qualify, will enable us to reduce the number of individuals who churn in and out of Medicaid on a routine basis,” the state said in the waiver.

{mosads}Mississippi is the latest state to request federal approval for waivers with Medicaid work requirements. The Trump administration recently announced new guidance intended to encourage states to apply for such waivers, something that has never before happened in the 50-year history of the Medicaid program.

Kentucky was the first state to receive approval for a waiver.

Unlike Kentucky, which received additional federal money to expand Medicaid under ObamaCare, Mississippi did not expand coverage, but is still seeking additional federal funding to implement the job training requirements.

Kentucky is also targeting its work requirement at the “newly eligible” population of childless adults.

Mississippi doesn’t cover that population, so its requirements are targeting low-income parents and caretakers. Exemptions to the requirements can include people who are disabled, their caretakers, or people physically or mentally unable to work.

Mississippi is one of the poorest states in the country, and consistently ranks among the worst in the nation in terms of overall health of its citizens.

The state also has very strict Medicaid eligibility rules. In order to be covered, a single parent has to earn less than $227 a month, or less than $5,600 a year for a family of 4.  

Critics have said that once these people are working, they will likely earn too much to qualify for Medicaid, even though the jobs available are not likely to offer health insurance.  

The state acknowledged those concerns, and noted the waiver “in and of itself is not enough to guarantee successful transitions to other health insurance. However, we believe this waiver is the first step in properly assessing workforce training activities and their impact on the Medicaid population.”

The state already accepted public comments on the proposal. Federal comments will be accepted through Feb. 23.

The state received 11 written comments; only one of them was favorable to the proposal.