Work requirements for Medicaid beneficiaries did make it through a Florida House committee on a 14 to 4 vote in the just-ended legislative session. The Trump administration recently showed a positive reaction to work requirements for Medicaid beneficiaries. However, the Florida Legislature did not enact this type of requirement in the current legislative session.
Work Requirements for Medicaid Beneficiaries: Florida’s House Speaker Says No
Florida House Speaker Richard Corcoran, R-Land O’ Lakes, told The News Service of Florida that the state’s $26 billion Medicaid program is comprised mostly of children and seniors. The work requirements proposed in other states are designed to address able-bodied adults who qualify for Medicaid under the Affordable Care Act (known as “Obamacare”).
“I think that’s geared toward Obamacare expansion, not to our plan since we didn’t expand,” Corcoran said of imposing work requirements. “We don’t have childless able-bodied working age adults in our system, so I don’t know how that would transpose to us. If you look at our Medicaid population, mostly children, mostly seniors, and single pregnant moms, I don’t think that is necessarily something that we would do.”
Florida’s Medicaid Program Nation’s Fourth Largest
Florida currently has roughly 4 million people enrolled in its Medicaid program. That makes it the fourth largest in the nation in terms of population, according to Medicaid Director Beth Kidder. Estimated spending on the Medicaid program will be just under $27 billion in 2018—that would be the fifth-largest program in the nation in terms of spending.
Kerri Wyland, a spokeswoman for Governor Rick Scott, sidestepped an answer as to whether the governor would support work requirements for Medicaid beneficiaries or co-payments for the Medicaid program. “This would require legislative action. Governor Scott will review any bill that reaches his desk,” she remarked.
Last month, the Trump administration sent a letter to state Medicaid directors announcing a policy to authorize work requirements for Medicaid beneficiaries for states with what are known as “Medicaid 1115 waivers.” Florida has such a waiver.
“Subject to the full federal review process, CMS (the federal Centers for Medicare & Medicaid Services) will support state efforts to test incentives that make participation in work or other community engagement a requirement for continued Medicaid eligibility or coverage for certain adult Medicaid beneficiaries in demonstration projects authorized under section 1115 of the Social Security Act,” the letter said.
“Such programs should be designed to promote better mental, physical, and emotional health in furtherance of Medicaid program objectives. Such programs may also, separately, be designed to help individuals and families rise out of poverty and attain independence, also in furtherance of Medicaid program objectives.”
States would have the ability to identify activities other than employment that promote health and wellness. These activities might include community service, caregiving, or job training.
Work Requirements for Medicaid Beneficiaries is a Priority for Republicans
Requiring work thresholds for Medicaid eligibility has been a long-standing priority for conservatives. The Trump administration announcement reverses previous policies that prevented states from requiring Medicaid beneficiaries to work to qualify for program benefits.
Although House Speaker Corcoran announced that his chamber won’t move forward with the work requirement in 2018, the Republican-led chamber did look at the idea last year. Representative Travis Cummings, R-Orange Park, introduced a bill in 2017 that would have required all Medicaid beneficiaries who are part of the state’s “managed medical assistance” program to satisfy to the same work requirements that apply to families who receive temporary cash assistance.
Cummings’ bill also would have required Medicaid enrollees to pay monthly premiums to stay enrolled in the managed medical assistance program, which involves enrolling in managed-care plans.
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