Should people who receive health insurance coverage through Medicaid be required to work?
It’s a question Georgia policy makers are likely to engage with as they prepare waivers to tweak the state’s Medicaid program.
Georgia officials awarded consulting firm Deloitte a nearly $2 million contract this week to help develop those waivers, and the company appears very interested in promoting work requirements as part of Georgia Medicaid.
“The Deloitte Team understands the relationship between healthcare coverage and employment,” reads the company’s pitch to state officials. “Georgia will benefit from the many lessons we have learned to help … states implement Medicaid community engagement requirements.”
The concept is simple: people on Medicaid should work to receive benefits, if they’re able to do so. At they very least, they should be involved in job training or dedicate time to volunteering.
Those who support work requirements argue getting people into jobs reduces their need for Medicaid: either they’ll start making enough money to be self-reliant or will be able to get insurance through their employer.
“We owe our fellow citizens more than just handing them a Medicaid card,” said Seema Verma, head of the Centers for Medicare and Medicaid Services (CMS), in a 2017 speech. “We owe a card with hope that they can one day … no longer need public assistance.”
In the time since, Verma’s support for work requirements hasn’t wavered. CMS issued a policy brief in support of them in early 2018.
According to the National Academy for State Health Policy, the agency has approved them in nine states.
Georgia could be the next to submit such a request. First among Deloitte’s “critical goals” for the state is “incenting work-related activities in Georgia’s Medicaid program.”
But work requirements have their fair share of opponents.
“It’s not something that helps people work. It’s something that prevents them from getting healthcare so they can work,” said Laura Colbert with patient-advocacy group Georgians For A Healthy Future.
She argues work requirements don’t lift people out of poverty, but simply kick people off Medicaid.
Thousands of people lost coverage in Arkansas after a work requirement was imposed there last year. It was eventually struck down by a federal judge.
But that didn’t stop the Trump administration from forging ahead. It approved work requirements in Utah just two days later.
“The Trump administration has shown it thinks this is a really important part of health reform and making sure that people have the full range of things they need to be self-sufficient,” said Kyle Wingfield with the right-leaning Georgia Public Policy Foundation.
That’s why he expects to see more states ask for work requirements for their Medicaid programs. By one count, six have pending applications before the feds.
Georgia officials say they hope to submit their Medicaid plans to the Trump administration by the end of the year.