Requiring work for Medicaid: Ruling in Kentucky echoes in Georgia


Many Georgia officials cheered as the Trump administration moved toward work requirements for Medicaid recipients. Medicaid is the federal health care program for the poor, elderly and disabled.

Now those officials’ hopes are stalled, as the effort ran into a roadblock last week — and those who oppose the work requirements are taking heart.

Supporters see the work requirements as a way to help people escape poverty and say that would lead to better health. Opponents view the requirements as a way to knock people off Medicaid’s rolls.

A federal judge in Kentucky last week said a maiden attempt in that state to impose work requirements for Medicaid recipients was not done legally.

It’s not a knockout blow nationwide, or even in Kentucky. The administration can appeal, and not every state’s plan will be the same as Kentucky’s.

But the judge’s ruling went right to the plan’s weakest legal point. The judge’s central reason for blocking the plan was that the work requirements plan showed faint evidence of doing what Medicaid is legally supposed to do: to provide medical assistance.

Now the plan goes back to the federal government for revisions.

Meanwhile, Georgians are taking stock. For Georgia, it all comes down to the possibility of Medicaid expansion.

Right now, few Georgia patients would be affected by the work requirements right away because few poor working-age, able-bodied adults can get Medicaid at all. When the Affordable Care Act was passed, it left the very poorest to be covered by Medicaid, though the courts said that would be up to the states. The issue became politically sensitive, and conservative states including Georgia decided not to expand Medicaid to cover those poorest.

Georgia’s leading Republican officials have said the long-term cost to the state is just too much.

Now, some Georgia conservatives are willing to consider some version of Medicaid “waiver” that could allow more people to receive coverage. But they’d also like to see work requirements.

“I do think it makes sense for Georgia to pursue a waiver and try to use some of the Medicaid dollars that Congress has made available to help people pay for private insurance,” said Kyle Wingfield, the president of the libertarian-leaning Georgia Public Policy Foundation. “And I think the way that’s probably going to work best is if they also have some employment.”

The work requirements controversy may further intensify polarizing issue.

“Where the Democrats may not want to participate in work requirements and Republicans might want to participate in work requirements, if there’s ever anything that would further define the parties, that’s it,” said Jimmy Lewis, a consultant to rural hospitals.

Under Kentucky’s plan, it could require able-bodied poor adults to prove they worked or performed community service in order to receive Medicaid, and have them pay a monthly premium.

The federal official leading the charge on Medicaid work requirements is Seema Verma, the administrator of the Centers for Medicaid and Medicare Services. She says requirements will help people be healthy, since studies show people with jobs tend to be healthier. For example, people with jobs tend to be less depressed and have longer life spans.

An opponent of Medicaid work requirements, Laura Colbert of Georgians for a Healthy Future, said the real effect would be to drop people off Medicaid when they have trouble getting the extra red tape done.

“Especially when you’re talking about people who are already poor, they tend to have less access to technology, less time off from work to go file paperwork,” she said. “Health insurance is really there to allow people to be healthy enough to work. Work should not be the requirement to get to be healthy.”

Stay on top of what’s happening in Georgia government and politics at PoliticallyGeorgia.com.


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