Work requirement for some Medicaid enrollees?



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.


  1. Can’t wait to hear what “…a modest level of employment” is…

    or what employer (besides government) is expected to hire somebody whose interest is limited to “…a modest level of employment”.

    Then there’s ““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” which, loosely translated, means:

    “We want 50 more government employees (and they can only be government employees, because nobody in the private and/or non-profit sector can do this!) to hand out money to bums and we need to figure out how to force an income tax on productive Alaskans to make it happen.”

  2. Yes, there really is some irony in the administration that called legislators back to Juneau time after time to shove an income tax down our throats now protesting through testimony and the fiscal note a very modest effort to put able-bodied people to work, at least if they’re on the dole. I think Walker and Mallott, and their Juneau advisers, see the world as having two classes. One class is Republicans and independents who are born to work, pay taxes and keep their mouths shut according to Walker and Mallott. The other class is Democrats who either work for government or don’t work at all. Fortunately we have a genuine opportunity this year to vote out Walker and Mallott.

  3. Have you noticed how, once established, entitlements never go away and never get smaller? A rare exception to that was the Longevity Bonus, but that only went to old people.

    I have written multiple times in multiple forums: If the growth of the Medicaid program is allowed to continue at the current rate, it will consume ALL OF THE AVAILABLE GENERAL FUNDS of the State.

    Even a few on the Left, notably the teachers and their union, should take a moment to think about this.

  4. Requiring people on Medicaid work if they can is a positive goal. But 79 million to administer the project? Holy cow. Here’s an idea. Instead of trying to make people work why not focus on requiring some people on Medicaid help pay for it instead…at least something. Then that gives them the incentive to find a job to help them make those payments. If you focus on Medicaid receipients just finding work you get no relief on the amount of monies spent on medicaid itself unless a person makes enough to disqualify for medicaid benefits. But if they have to pay into the program itself you get a double benefit. Incentive to find work & payment toward the cost of benefits yielding some taxpayer relief.

  5. So to get “Medicaid Expansion” in at first the feds paid the bulk of it. That “Subsidy” went away and now we pay the full cost. That is the “Core” cost. Now the ripple costs. 50 more employees skirted around the hiring freeze. Walker sux, plain and simple. 50 more solid union Democrat voters.

  6. Time for a new administration, one that gets ‘it’.

    $79,000,000 for 53 bureaucrats? If that’s the case we don’t even have to fire half the state government to close the spending deficit! Each bureaucrat costs $1,490,000? This governor has failed at doing his job as executive if each state employee costs $1,490,000.

  7. How about requiring newly released felons who are eligible for Medicaid Expansion to have a work requirement? A newly released felon who may have assaulted you or your family members, who may have robbed you, who may have stolen your care (multiple times) is put on Medicaid Expansion by the State. Irony!

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