Work Requirements For Medicaid Exposes Ideological Divide
HARTFORD, CT — There are 800,000 Medicaid recipients in Connecticut, but 72 percent of them would not be impacted by a Medicaid work waiver because they are children under 19, adults over 65, persons with disabilities, or employed.
But several lawmakers spoke passionately Thursday both for and against a bill, which seemed to expose an uncomfortable ideological divide.
Republicans believe people receiving Medicaid should be required to fulfill work obligations that will lift them out of poverty, while Democrats believe healthcare is a right for anyone who is eligible.
She said a majority of Walmart, Stop & Shop, and Dunkin Donuts employees are on Medicaid because they can’t get enough hours to qualify for insurance or they simply don’t make enough money and “need a hand up to help them with their medical.”
Abercrombie said taking away health insurance from this population isn’t going to stop them from getting sick. She said they will show up at the emergency room and “we all know as a state what we pay for people who are not insured.”
She said Medicaid “isn’t a job promoter. It’s a health insurance policy.”
Rep. Jason Perillo, R-Shelton, said Connecticut has created a health insurance that is so good “that in many cases there may not be an incentive to get off it.”
He said while many may already have a job there’s 28 percent who are not working and should be able to work. He said some are disabled, but not all of them. He pointed out there are already work requirements for other so-called welfare programs, such as Supplemental Nutrition Assistance Program, and TANF.
“We’re talking about giving Medicaid recipients an opportunity to work, go to school, volunteer, to be productive,” Perrillo said. “Maybe we have different perspectives on how we achieve that goal, but that is the goal.”
He said they want them to get a better job that will lift them out of poverty.
Rep. Terry Adams, D-Stamford, said he was just listening to the debate over opening the bidding process for a casino in Bridgeport and learned that there are more than 9,000 people in New Haven and Bridgeport who are struggling to find a job.
“There’s no jobs, yet you’re saying everybody ought to be able to work,” Adams said.
Perillo said not everybody can get a job just because they want one. He said an individual has to be actively looking for employment or volunteering 20 hours per week or attending school.
“I see no reason why that concept of seeking employment, which ideally gets us to a point where individuals are eventually employed,” Perillo said. “Eventually they’re going to get there.”
Adams wondered what Perillo would do if he lost his job, ran out of unemployment benefits, and was suddenly unable to provide for his family. He said Toys R Us is about to lay off 33,000 people and what happens if those people are unable to find jobs within the next six months?
Perillo suggested if a person doesn’t have the skills then they can return to school to get the skills they need for a job.
But without any money to pay the bills then how do you afford school and still pay the bills?
“How do you maintain your household?” Adams said. “Tell me in reality how do I get there?”
Perillo said it’s unfortunate this discussion is happening with just the Human Services Committee because it involves so much more than that and can’t be discussed in a “silo.”
“That’s our collective failure,” Perillo said. “We have not cooperated and collaborated across agencies to enable that.”
He said there is “no jobs plan that corresponds with an education plan that addresses the individuals on Medicaid.” He said they can’t keep talking about these things in silos.
Rep. Brandon McGee, D-Hartford, said in his district more than half of the Medicaid recipients work and many of them are working more than one job.
“Connecting work requirements to one’s health care coverage is absolutely absurd,” McGee said. “It is ridiculous.”
He said it feels like Trump is “attacking working people” in the state of Connecticut.
In January, the Trump administration issued guidance to states that would allow them to impose work requirements on the Medicaid population as a condition of eligibility.
There are nine states that have applied for these waivers and the Centers for Medicare and Medicaid Services has approved the program for three states. There are six states still awaiting approval.
Social Services Commissioner Roderick Bremby said there’s already a lawsuit filed against Kentucky for moving forward with the waiver. It alleges that the federal health officials who approved the plan acted illegally and in conflict with Medicaid law that only Congress has power to change.
Bremby also pointed out that the federal government did not provide any financial support for states to make these changes to the program. From verifying work data to helping Medicaid recipients obtain training or jobs, there is no financial support for imposing the work requirement.
Rep. Melissa Ziobron, R-East Haddam, said they need to weave these types of programs together with others to find cost savings because the next legislature is staring down a $5 billion deficit.
“Tough, tough decisions will have to be made, Ziobron said.
Abercrombie said she doesn’t believe this legislation gets them any further toward closing a budget gap.