(KPLC) - By Kaylee Poche
and Ryan Noonan
LSU Manship School News Service
BATON ROUGE - Even though requiring Medicaid recipients to work is one of the few areas in which Governor John Bel Edwards and Republican legislators agree, experts say implementing the rules may not have much of an impact.
House Speaker Taylor Barras, R-New Iberia, proposed Medicaid work requirements in a letter to the governor last week, and Edwards has long said he supported the general concept. The governor's aides met with Trump administration officials in Washington last month to discuss the details, including what would be considered "work" under the program.
Under the speaker's proposal, Medicaid recipients aged 19 to 64 would be required to work a minimum of 20 hours a week unless they are caretakers, full-time students, pregnant women, recipients of unemployment compensation or medically certified as unfit for employment.
But about 70 percent of Medicaid adults are already working, according to the Andrew Tuozzolo, chief of staff for the Louisiana Department of Health.
"Of the 30 percent of those who aren't working, only a small part of those folks are able-bodied and able to work," Tuozzolo said in an interview. "Many of these people are students, disabled or family caretakers."
Tuozzolo added that the Medicaid work requirements probably would not save much money as the state tries to close a looming $1 billion budget shortfall. Long-term savings for the state remain indefinite, he said.
Louisiana legislators have also expressed similar concerns.
"I'm skeptical that it's going to be any real savings," said Rep. Kirk Talbot, R-River Ridge. "I like the concept, and I believe in the concept, but I'm not counting on that being a lot of saving that we can point to right away."
Tuozzolo said designing a Medicaid work requirement would involve researching the obstacles that Medicaid recipients face in finding jobs and developing strategies to overcome them.
"We do believe that we need to find opportunities for those folks looking for work through other means," Tuozzolo said. "We're in the process right now of working with consultants and stakeholders to develop an effective, visible plan that benefits Louisianans on Medicaid and understand, for those people who aren't working, what barriers are stopping them from working, whether it's educational attainment or transportation."
While the effectiveness of work requirements for government assistance programs has been questioned over the years, public support for the idea has remained relatively high. According to a 2017 poll from the Kaiser Family Foundation, 70 percent of Americans favored requiring Medicaid recipients to work.
This would not be the first time the government has enacted work requirements for government assistance programs, a policy Republicans and centrist Democrats tend to favor.
In 1996, President Bill Clinton signed into law the Personal Responsibility and Work Opportunity Act to change the nation's welfare system. Replacing the Aid to Families with Dependent Children program, the Temporary Assistance for Needy Families program mandated recipients of federal cash assistance to meet work requirements.
The goal of the bipartisan reform was to refine the welfare system into one which promoted a smoother transition into the workforce. Over 94 percent of Americans supported the reform, according to a survey by the Washington Post, and support still remains high.
But in 2012, President Barack Obama decided to let states to loosen work requirements for welfare recipients, saying the requirements were too restrictive and that more people would have success finding jobs without them.
Opponents of Medicaid work requirements are now expressing similar concerns, adding that they might discourage those who qualify for Medicaid from applying to the program.
Enacting Medicaid work requirements requires a waiver from the federal government. The Trump administration announced in January that it would shift from Obama's policy and begin allowing states to implement work rules.
Kentucky quickly became the first state to receive a waiver to implement the Medicaid work requirements, and its program is set to take effect in July. On Friday, Indiana became the second state to receive a waiver. Eight other states have submitted similar requests -- Arizona, Arkansas, Kansas, Maine, Mississippi, New Hampshire, Utah and Wisconsin.
Three organizations opposing the program, the National Health Law Program, the Kentucky Equal Justice Center and the Southern Poverty Law Center, filed a federal lawsuit on behalf of 15 Kentuckians who could lose coverage, stating that the Trump administration has "effectively rewritten the statute, overturning a half-century of administrative practice, and threatening irreparable harm to the health and welfare of the poorest and most vulnerable in our country."
Tuozzolo, the Louisiana health official, has stated that there will be differences between its program and the ones in other states. He said the program is "a high priority project" for the health department and Louisiana but is still in the data research phase.
"We're focused on a Louisiana-specific plan," Tuozzolo said. "We're not trying to copy a plan from a state that doesn't look like Louisiana, that has a completely different population and certainly has different needs and interests in terms of their policy."