Advocates say Medicaid work proposals will target women
"Who is going to help recipients find gainful employment?" Edwards said at a public hearing on the proposed changes. "Who will provide child care for recipients who get gainful employment? Will new caseworkers be hired or will the state rely on already-overburdened workers?"
The comments came amid Alabama Medicaid's proposal to impose some work requirements on the parent and caretaker (POCR) population, a group of about 74,000 people who represent virtually the only able-bodied adult population that receives Medicaid benefits in
Most of
A person working a weekly 40-hour minimum wage job makes
"It leaves me feeling that we are making an attempt to demonize poverty," said
Alabama Medicaid estimates each person in the POCR population costs an average of
The agency said in its waiver application that it believed "increasing employment among parents and caretakers through employment and job training requirements will improve health outcomes and economic security among this population and their families." Work would include full-time employment, job or technical training, education activity or volunteer work.
The agency wants to exclude disabled individuals; pregnant women; people over the age of 60; people taking care of a disabled child or adult and people undergoing addiction treatment from the work requirement.
It is not clear how many current enrollees the changes would affect. A public document issued by the department projects that the POCR population would stand at 67,543 in 2023, which the agency said would be 17,000 fewer than projected that year.
Critics of the move did not dispute the benefits of labor but said the state fails to provide the kind of support -- particularly for child care and transportation -- that those in poverty need to make the transition to the workforce.
"Even if they could find work and pay for health care, they're faced with child care needs," said Linda Lee, executive director of the
Other states, like
Lee and other speakers also said losing insurance would either make households more vulnerable to illness or force them to choose between health care and other needs.
"It's critical to remember that the real intent of this proposal is to take health insurance away from women targeted by the waiver request," she said.
Edwards also noted that the POCR population already has a host of responsibilities.
"Parenting and caretaking is work," she said. "For there to be an implication that people taking care of people under the age 19 or other disabled adults are not working is quite incorrect. Bringing up the next generation of children is quite honorable."
The agency plans its second and final public hearing on the proposal at the
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