Work requirement for some Medicaid enrollees?

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WALKER ADMINISTRATION SAYS THAT WILL BE ANOTHER $79 MILLION

The Walker Administration testified it needs up to 53 new employees at the Departments of Health and Social Services and Administration to ensure Medicaid-enrolled able-bodied adults seek employment, enroll in school or training, or become volunteers.

The expanded state workforce would include administrative judges to hear appeals from those who challenge eligibility decisions based on the work requirement.

SB 193, a bill that would require able-bodied Alaskans enrolled in Medicaid to obtain a modest level of employment was heard in Senate Finance Committee on Tuesday and the hearing will continue on Wednesday.

With SB 193, no more than 20 hours of work-like activity would be required of this “Medicaid Expansion” population, which is estimated to be 25,000. These are the people who enrolled when Gov. Bill Walker expanded Medicaid in 2015 to able-bodied adults without children who are under 138 percent of the federally set poverty level.

There are numerous exceptions in the work requirement for those who are parents of minors, who are caregivers, or who are over the age of 64, victims of domestic violence, or pregnant, for example.

The Walker Administration says the requirement would cost the State budget almost $79 million. That amounts to spending $3,160 on each of the Medicaid enrollees that lawmakers want to see making an effort to work or contribute to society.  With the administrative law judges included, it represents the creation of a significant new bureaucracy in order to impose a work requirement.

The sponsors of SB 193 say they want Alaskans who can work to wean themselves off of state benefits when possible and not make a lifestyle of collecting benefits. A job is the quickest way to get on the road to self-sufficiency. Sen. Pete Kelly of Fairbanks is the bill’s prime sponsor.

Upon hearing the Walker Administration’s cost estimate for the program, which the Administration says could also cost it federal funding, Senate Finance Co-Chair Anna MacKinnon hit the proverbial buzzer:

“Deputy Commissioner [John] Sherwood, I just would say that this is one of the most interesting fiscal notes I’ve seen. I appreciate the detail that you have and it appears the department does not want to do this.” – Sen. Anna MacKinnon

Later, MacKinnon said that she’d been on Finance for a long time and had heard many fiscal notes, but never had seen one like this.

“Fifty positions is a round number that the department continues to give us in multiple fronts trying to get more bodies in the Department of Health and Social Services for Medicaid expansion,”  she said.

Monica Windom and John Sherwood testify.

The fact that Commissioner Valerie Davidson was not the one on the hot seat in front of the committee made it clear that this was not the Administration’s idea of a good plan, and it was the mission of Sherwood and Monica Windom, who directs the Division of Public Assistance, to fend off the requirement. That’s a signal that the governor is unlikely to sign such a measure, even if it makes it through the Democrat majority House.

SB 193 follows the Trump administration’s ruling that allows states to place expectations of work on Medicaid beneficiaries who are able to work.

The state already has a work requirement for the Alaska Temporary Assistance Program, which provides cash assistance and work services to low-income families with children to help them with basic needs while they work toward becoming self-sufficient. ATAP is a subsection of the federal Temporary Assistance for Needy Families block grant.

SB 193 would have the state request a “waiver” from the federal government to start a 20-hour-per-week requirement. The Trump administration has approved similar waivers for Indiana and Kentucky, and several other states have work requirements pending.