EDITORIAL: Medicaid reform?

April 29--The state House has passed a bill that would force "able-bodied" Medicaid recipients to work at least 20 hours a week or complete job training programs to retain their health insurance coverage.

We believe the effort has merit but is lacking a better definition of "able-bodied," which on the surface is open to broad interpretation. During a discussion among the Trib's Westmoreland editorial board, one member noted, for example, that people with mental illness who are not institutionalized would be considered "able-bodied" and required to fulfill the requirement.

Fayette County Republican Matthew Dowling, its prime sponsor, says House Bill 2138 applies to the 800,000 "healthy adults" that became eligible for Medicaid since its expansion in Pennsylvania in 2015. Medicaid disbursements emanate from state and federal finds.

Dowling claims that half of the "healthy" adult Medicaid recipients make no attempt to work.

He says that one in four Pennsylvanians depend on Medicaid for their health insurance, covering many more than the most vulnerable people it is intended to help.

Opponents, including Democratic Gov. Tom Wolf and health care patient advocates, lump the bill among the attempts by Republican-controlled legislatures to scale back Medicaid after Congress failed to repeal Obamacare.

Dowling's bill adds exemptions that a previous work-mandate bill didn't include. Wolf vetoed that bill. Dowling's most recent bill passed the state House 115-80, with all but a handful of Republicans voting for it and all but a handful of Democrats against it.

It is possible that the proposal could help to curtail fraud that is widely believed to exist within Medicaid. We also side with Dowling when he says the state Department of Human Services' estimate of $800 million to implement the bill seems grossly exaggerated.

There are questions to be sure within the proposal -- that "able-bodied" one stands out -- but there is validity in the bid to require people to work at least some to receive government health care.

Or not be in the program at all.

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