Florida House members pushing Medicaid work requirements

Florida lawmakers are considering requiring an estimated 500,000 Medicaid beneficiaries to work or show they are trying to get jobs to keep their health-care benefits, despite recent court rulings that have struck down similar requirements.

Members of a House health care panel this week approved the proposal (HB 955), which is now ready to go to the full House.

While the Senate hasn’t considered the proposal this legislative session, the notion of a work requirement is supported by Sen. Aaron Bean, a Fernandina Beach Republican in charge of crafting the Senate’s health care spending plan.

“I would be interested in that,” Bean said when asked about the issue.

The House is moving forward with the legislation after a pair of rulings by U.S. District Judge James E. Boasberg that tossed similar work requirements in Kentucky and Arkansas. Boasberg serves in the District of Columbia.

Mandating work requirements has been a long-standing priority for conservatives. In a party-line vote, members of the House Health & Human Services Committee on Tuesday approved the Florida bill, sponsored by Rep. Daniel Perez, R-Miami.

The proposed work requirement would hit low-income adults who have children.

“The true intent of this bill really is good at heart. It’s just to make sure that the individuals who are able to work, that are able to get back to our society, are doing so if they are receiving government benefits,” Perez said.

But Joan Alker, executive director of the Center for Children and Families at Georgetown University, disagreed.

“If this bill becomes law, it would be the harshest (and that is saying something!) that I have seen so far — with no parent excluded unless they have a newborn under 3 months old,” Alker wrote in her blog, describing the bill.

Florida has the fourth-largest Medicaid program in the nation in terms of the number of beneficiaries and the fifth-largest program in terms of expenditures, according to state Medicaid officials. The program covers nearly 4 million people — mostly through Medicaid managed care plans — and costs more than $28 billion.

Not all low-income people in Florida qualify for the Medicaid program. The state determines eligibility, and lawmakers have set different eligibility requirements for different groups.

For instance, pregnant women can earn almost twice as much as the poverty level, which is $12,140 for an individual, and be enrolled in the Medicaid program. Florida has not expanded Medicaid to able-bodied childless adults.

The House bill would direct the Agency for Health Care Administration to request federal approval to require beneficiaries to engage in work activities to remain eligible for Medicaid coverage. The bill would exempt people who receive Medicaid long-term care coverage, such as seniors in nursing homes.

The proposed work activities mirror those already included in a state temporary cash assistance program. Florida requires the maximum number of work hours allowed under federal law, which means, for example, that single parents with children over age 6 are required to work 30 hours per week.

The proposed Medicaid work requirements would not apply to the large number of children who receive health care through the program and are not expected to apply to people who qualify for  Social Security Disability Income.

Katie Betta, a spokeswoman for Senate President Bill Galvano, R-Bradenton, said in an email Wednesday that Galvano is “open to work requirements for able-bodied adults.” But she said his support in the past for such ideas also involved wanting options to meet the requirements, including on-the-job training, job-placement activities and pursuit of educational opportunities. She also said he has wanted exceptions for people with disabilities and caregivers of people with disabilities.

Karen Woodall, a longtime social-services lobbyist, told House committee members that Medicaid and the temporary cash assistance programs aren’t the same. One program provides money, she said, while the other provides health benefits.

Requiring Medicaid beneficiaries to work would likely result in people losing coverage, said Woodall, executive director of the left-leaning Florida Center for Fiscal and Economic Policy.

Also, the jobs Medicaid enrollees are able to secure may not come with benefits such as health insurance, she said, adding that would leave them with little money and no health care coverage.

“I would encourage you to look at a different approach in assisting the folks  and see what kind of help can be there without tying loss of their health insurance to it, because you are just going to exacerbate the loss of their health insurance to it,” Woodall said.