Missouri is looking at work requirements for Medicaid

Jan. 26--JEFFERSON CITY -- Missouri appears headed toward requiring Medicaid recipients to find jobs to receive their benefits.

On Jan. 11, President Donald Trump's administration announced it would allow states to implement work requirements for adults under the age of 65 on Medicaid who don't have disabilities or who are pregnant. The next day, Kentucky was granted a waiver to its Medicaid program that allowed work requirements.

The Missouri agency overseeing Medicaid spending is reviewing the Trump administration's new guidelines on work requirements and Kentucky's approved waiver, which was the subject of a lawsuit filed Wednesday, agency spokeswoman Rebecca Woelfel said.

"The Department of Social Services is working to move forward on this waiver" to the Medicaid program, she said, "but legislation is needed to fully implement and uphold the change in eligibility."

Sen. David Sater, R-Cassville, introduced legislation this year that includes a provision about work requirements for Medicaid recipients. He introduced similar legislation last year that didn't go anywhere.

But in light of the Trump administration's new guidelines, he said his bill has a much better chance this year.

"Getting people back to work is one of the most important things we can do," Sater said. "There's jobs everywhere right now. Driving up to Jefferson City I passed three or four different industries with big signs out there, starting pay $12.50, $13 an hour. It's not for a lack of jobs right now."

Sen. Ron Richard, R-Joplin, the leader of the Senate, said he agreed with the objective of the legislation, but he deferred questions to Sater.

Roughly one million Missouri residents rely on Medicaid, according to 2016 department data, the latest available. Most cannot work.

Woelfel said that of the 89,397 individuals who would be mandated to comply with the work requirement, 17,306 already are.

Sater said the change in work requirements would affect a small pool of people -- some states had more than a million non-elderly adults without disabilities on Medicaid in 2016, according to data from the Kaiser Family Foundation.

"Ours is real small problem," Sater said. "Everybody that should be working should be working."

Under Kentucky's waiver, able-bodied Medicaid recipients would need to complete 80 hours a month of "community engagement," which includes working, taking job-training courses, or attending school, according to the Associated Press. That's in line with the federal requirement to receive another kind of social welfare benefit -- food stamps.

On Wednesday, 15 people in Kentucky sued the federal government over the policy change, according to the AP. It's estimated the policy change would result in about 95,000 people in Kentucky losing Medicaid coverage over the next five years. In his budget proposal, Gov. Eric Greitens called for a $40 million cut in Medicaid spending.

He also asked for additional funding for some Medicaid services that, he said, would lead to state savings in the future: $1 million to fund an "independent, objective assessment" of the state's Medicaid spending, and about $10 million to upgrade the computer system that processes claims.

But the proposal said nothing about Medicaid work requirements, and Parker Briden, the governor's spokesman, said the governor's office had no comment about the policy change at this time.

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