Red states may expand Medicaid for more work

WASHINGTON — Kentucky Republican Gov. Matt Bevin says he doesn’t want more ablebodied poor people to get Medicaid unless a portion of them are required to work.

And when Republicans in Virginia agreed to expand Medicaid this year, they also said recipients who are able would have to work.

In several states this year, the march to bring health care benefits to more low-income residents came with the insistence that able-bodied adults, who are just a fraction of all Medicaid recipients, put in hours of work or volunteer time each month to retain the assistance.

The politics worked: Many Democratic lawmakers went along as assurance that more people could reap benefits from the Affordable Care Act, while Republicans were able to show their base that they were holding people accountable for receiving aid. As a result, Republican-led states have increasing- ly expanded coverage with such restrictions, and some red states that had already expanded Medicaid are opting to add them.

According to the Kaiser Family Foundation, more than 6 in 10 adult Medicaid enrollees are already working in a variety of jobs, including retail sales, home health care, restaurants and hotels, cleaning services, transportation and customer service. And about a quarter of nonworking adults would be exempt from state work requirements for health reasons or because they are caring for a child or ailing family member.

As a result, only a small share of the targeted adult Medicaid population, 6 percent, would be subject to the restriction. But according to Kaiser and other research and advocacy groups, a much larger share of enrollees, both those who are working and those seeking exemptions, would be subject to reporting requirements and could fail to make timely filings, primarily because they do not have access to a computer.