Medicaid forum questions proposed work requirements

July 25--TUPELO -- Mississippi's Division of Medicaid frames a proposed work requirement waiver as a step up out of poverty, but consumer advocates see it as pulling the rug out from under vulnerable families.

During a Tuesday forum in Tupelo, the Mississippi Health Advocacy Program and Community Catalyst encouraged community advocates to oppose the proposed waiver, which is currently open to public comment through Aug. 18.

"They're trying to redefine what Medicaid is all about," said Amanda Ptashkin, project manager for Community Catalyst's Southern Health Partners program. "It's not a work program."

Mississippi Medicaid has filed a waiver proposing work requirements for a small group of working age adults on its rolls. It exempts children under 19, pregnant women, the disabled and those over 65. The proposed waiver primarily affects very poor parents and caregivers of other Medicaid recipients, about 57,000 of its 750,000 Mississippi Medicaid beneficiaries.

Within that group, parents of children under 6, students, caregivers for the disabled and mentally ill, those diagnosed with mental illness and those in treatment for addiction of cancer would be exempted.

The Division of Medicaid sees the waiver as a workforce training initiative and aims to connect some of the poorest Mississippians with better lives.

"If successful, the initiative will contribute to the improvement of health outcomes, promotion of financial stability and independence from government assistance," a Medicaid spokesman said in written responses to Daily Journal questions.

Advocates for Medicaid recipients see a proposal that adds red tape without benefit and creates a Catch-22 for vulnerable parents and caregivers who would lose their public health coverage without gaining resources to access subsidies on the health insurance exchange.

"People's access to health care is far too important to gamble on red tape," Ptashkin said.

Parents and caregivers of Medicaid recipients are eligible if household income is below 27 percent of the federal poverty level -- about $370 a month for a single parent and one child, Ptashkin said. Working the required 20 hours a week at minimum wage would bring in about $580 a month, well shy of the income needed to access subsidies in the federal health insurance exchange, yet would leave them ineligible for Medicaid.

Medicaid officials said there is flexibility to address the concerns advocates raise.

"Working in paid employment for at least 20 hours per week is not the only way to fulfill the Workforce Training requirement," a spokesman wrote.

Advocates are concerned recipients will have a difficult time showing they are meeting the requirements or that they qualify for exemptions, Ptashkin said. In Arkansas, 455 out of 10,000 people in a work requirement pilot group were able to correctly navigate the process to prove they were meeting the requirements or qualified for exemptions in the first month of the waiver program.

"That's when red tape gets in the way," Ptashkin said.

The Mississippi Health Advocacy Program continued the series of forums in Jackson on Wednesday and Biloxi today.

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