Com­mon sense or bur­den?

New work man­date is likely to trig­ger de­bate in states across U.S.

The Dallas Morning News - - Nation - An­drew Demillo and Gretchen Eh­lke,

LIT­TLE ROCK, Ark. — Repub­li­cans this past week be­gan to re­al­ize their longheld goal of re­quir­ing cer­tain adults to work, get job train­ing or per­form com­mu­nity ser­vice in ex­change for get­ting health cov­er­age through Med­i­caid.

Whether that’s a com­mon­sense ap­proach or an added bur­den that will end up cost­ing many Amer­i­cans their health in­sur­ance will now be de­bated in states across the coun­try con­sid­er­ing the land­mark change to the na­tion’s largest health in­sur­ance pro­gram.

To Med­i­caid re­cip­i­ents such as Thomas Penis­ter of Mil­wau­kee, it’s cre­ated un­cer­tainty about his abil­ity to have health cov­er­age.

He’s been un­em­ployed for four or five years and has re­ceived Med­i­caid for the last two. He sees a be­hav­ioral health spe­cial­ist to deal with anx­i­ety and said Med­i­caid has made a big dif­fer­ence in his life.

Penis­ter, 36, said he is not yet ready to re­join the work­force and is un­nerved by the prospect of po­ten­tially los­ing Med­i­caid. His state, Wis­con­sin, is one 10 that ap­plied to the fed­eral gov­ern­ment for a waiver seek­ing to im­ple­ment work and other re­quire­ments for sin­gle adults.

Yet his story also helps make the case for those who fa­vor some type of com­mit­ment from work­ing-age adults who ben­e­fit from Med­i­caid, the state-fed­eral health care pro­gram for poor and lower-in­come Amer­i­cans. Wis­con­sin Gov. Scott Walker, a Repub­li­can, said the change helps pre­pare re­cip­i­ents to leave pub­lic as­sis­tance.

Penis­ter’s sta­tus is un­clear, be­cause Wis­con­sin’s pro­posed changes would ex­empt any­one who is di­ag­nosed with a men­tal ill­ness or is men­tally un­able to work.

Repub­li­cans say work and other re­quire­ments will re­turn Med­i­caid to its orig­i­nal in­tent — to act as a stop­gap un­til peo­ple can find work. They say it has ex­panded far be­yond its ba­sic mis­sion.

But crit­ics of the pol­icy shift point to the num­ber of peo­ple who could lose cov­er­age, even if they meet the new re­quire­ments.

The pro­gram, cre­ated in 1965 for fam­i­lies on wel­fare and low-in­come seniors, now cov­ers more than 70 mil­lion peo­ple, or about 1 in 5 Amer­i­cans. It ex­panded un­der Pres­i­dent Barack Obama’s health care law, with a ma­jor­ity of states choos­ing to cover mil­lions more low-in­come peo­ple.

Ten states had pre­vi­ously asked the fed­eral gov­ern­ment for the re­quire­ment waiver, and oth­ers are sure to fol­low. On Fri­day, Ken­tucky be­came the first to have it ap­proved.


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