State Politics

You might need a job to be on Idaho Medicaid — if you’re among these 700

In this March 22, 2017 photo, Seema Verma, administrator of the Centers for Medicare and Medicaid Services, listens at right as President Donald Trump speaks during a March 2017 meeting at the White House. Work requirements for Medicaid could lead to major changes in the social safety net under Trump. The question: Should adults who are able to work be required to do so to get taxpayer provided health insurance?
In this March 22, 2017 photo, Seema Verma, administrator of the Centers for Medicare and Medicaid Services, listens at right as President Donald Trump speaks during a March 2017 meeting at the White House. Work requirements for Medicaid could lead to major changes in the social safety net under Trump. The question: Should adults who are able to work be required to do so to get taxpayer provided health insurance? AP file

Legislation introduced Tuesday in Idaho would require “able-bodied” adults on the state’s Medicaid program to hold jobs.

Kentucky was the first state to get federal approval to impose work requirements as a condition of getting Medicaid coverage, after the Trump administration in January signaled it would consider such waivers. Several other states, including Utah, have applied for approval to add work requirements.

The work requirements tend to be more broad than just “working.” Medicaid patients could also qualify if they’re searching for a job or in a job-training program.

It’s rare for “able-bodied” adults to be allowed on Medicaid in Idaho. The state restricts the health insurance program to children in poor families, people with disabilities, poor seniors and select patients, such as those with breast or cervical cancer.

Otherwise, adults only qualify if they have children and make less than 21 percent of poverty-level income, or if they’re a pregnant woman under or slightly above the poverty level.

Roughly 7 in 10 of Idaho’s Medicaid patients are children. Once you account for them, people with disabilities, pregnant women and other exemptions, the state counts about 15,400 “able-bodied” adults on Medicaid — just 5 percent of the Medicaid population here, according to the Idaho Department of Health and Welfare.

Of those, the vast majority already have a work requirement, Health and Welfare said, because they receive food stamps or are part of financial aid or child care programs. The agency estimates just 700 adults would be affected by Tuesday’s proposal.

What prompted the state to consider a work requirement — a new layer of rules that would apply to only 0.23 percent of people on Medicaid?

“We were hearing from certain members (of the Legislature) that they were wanting these work requirements in there,” Health and Welfare Director Russ Barron told The Spokesman-Review Wednesday morning.

There were about 78,000 adults on Idaho Medicaid in fiscal year 2017, and about 223,000 children.

Nationwide, the Kaiser Family Foundation says more than half of adults on Medicaid who aren’t elderly or disabled already have jobs.

In Idaho, the “work requirement” language was added into an existing bill that would set in motion a two-pronged plan that state officials have been developing for months. That plan, if approved by the federal government, would give poor, uninsured Idahoans access to federally subsidized health insurance while moving some privately insured patients with expensive medical conditions onto Idaho Medicaid.

“The department shall seek a waiver to establish work requirements for able-bodied adult Medicaid participants,” the new bill language says. Those requirements “shall be consistent with the work requirements in the Supplemental Nutrition Assistance Program [food stamps] and the Temporary Assistance for Families in Idaho [financial aid] program.”

Audrey Dutton: 208-377-6448, @audreydutton

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