A much-derided bill that would force 'able-bodied' Medicaid recipients to seek work is making its way through the Minnesota Legislature.
Sen. Tony Lourey (DFL-Kerrick) is an outspoken opponent of the Republican-backed idea, but had an idea he thought might improve it. Last week, Lourey offered an amendment to take away legislators’ state-provided health insurance unless they work with the very people the bill would affect.
Lourey introduced this provision during a Senate committee on Thursday. Had it been adopted, his amendment would’ve required legislators to work at their county human services agency when the Legislature was not in session; if a lawmaker did not complete 40 hours of work per month, they risked losing their state-funded health benefits.
Lourey's amendment would've helped alleviate the strain on those who would be most affected by the GOP proposal: adults deemed physically capable of working, and county case workers who would have to handle an onslaught of paperwork. Lourey says lawmakers could "learn a lot about the type of people this would affect" by working side by side with county case workers making eligibility determinations for Medicaid, which in Minnesota goes by Medical Assistance.
“If you want to put this on these people," Lourey says, "you should go meet them.”
Lourey's point-proving amendment was voted down along party lines. Soon after, the bill authored by Sen. Mark Johns, R-East Grand Forks, was voted out of the Senate Health and Human Services Committee by one vote, with Sen. Scott Jensen, R-Chaska, who works as a doctor, abstaining, while the DFL minority voted unanimously against it.
The bill's House companion has also cleared committee hurdles, while likewise facing opposition, even from Republicans.
The Medicaid work requirement has come under fire in the weeks since its introduction in mid-March. Opponents say the bill would take health insurance away from the most vulnerable members of the population, especially those with physical and mental disabilities. Proponents argue the bill is narrowly tailored — only covering adults ages 18 to 60 who aren’t working, looking for work, or in school.
Johnson, the bill author, told the Senate committee he was following the lead of Arkansas and Kentucky, which recently passed their own work requirements for Medicaid.
“I understand that it’s difficult to bootstrap yourself off [Medical Assistance], but some may need a little extra incentive to do that,” Johnson testified.
Critics point out that Minnesota is not like other states that have passed similar work requirement laws. According to the Bureau of Labor Statistics, Minnesota has the second-highest workplace participation rate in the country, at 71.2 percent. Kentucky's 59.7 percent workforce participation ranks 43rd (59.7 percent) and Arkansas sits at 46th (58.5 percent).
“Minnesota works, and one of the reasons our people can work is because we’ve made a commitment to make sure that they have their health,” said Lourey.
Opponents also say the bill would be an administrative nightmare. If it becomes law, the state government would be required to monitor Medical Assistance recipients’ employment status. Doing so would mean the Department of Human Services and counties across Minnesota would have to go on a hiring bonanza, inflating the bureaucracy with hundreds of new case workers. The DHS estimates the bill could cost the state $7 million or more by 2021.
Lourey acknowledges the contributions of 201 state legislators would hardly have made a dent in the influx of new responsibilites. But he says determining who’s eligible for Medicaid would help them understand the reality of what it’s like to be on Medicaid.
“This [bill] is based on a fallacy,” said Lourey. “Most people use these programs when they need them and move on.”
A recent study from the American Economic Association found Medicaid expansion caused little to no reduction in employment levels, while an article in the Journal of the American Medical Association argued that Medicaid work requirements are a costly solution for a nonexistent problem.
“It’s not clear how much it would cost to implement such a program and whether that cost might exceed the savings,” the American Medical Association article stated. “It’s not even clear whether this program would achieve even the most basic rationale of incentivizing more able-bodied beneficiaries to work.”
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