MEDICAID

coverage under the Affordable Care Act’s expansion of Medicaid, which is tax-funded insurance for the poor and disabled.

The state would exempt those who are over age 55, in school or training for a job, in treatment for drug or alcohol addiction or have intensive healthcare needs or serious mental illness.

President Donald Trump’s administration this year has approved similar plans submitted by Indiana and Kentucky, and requests from nine other states — most of them Republican-led — are pending.

Earlier, federal officials encouraged tying coverage to employment by issuing guidelines for imposing work requirements, a reversal from President Barack Obama’s administration, which was focused on expanding coverage and turned down such requests.

Conservatives say such policies promote work, help people end their reliance on public assistance and save tax dollars by reducing Medicaid rolls.

“The importance of Medicaid is to help our neediest citizens, but we want people to contribute what they can,” said state Sen. Bill Coley, R-Mason. “The key is more people participating in the workforce and less pressure on the budget.”

Seema Verma, administrator of the federal Centers for Medicare & Medicaid Services, wrote in a recent op-ed in The Washington Post that “true compassion is lifting Americans most in need out of difficult circumstances. The new flexibility requested by states will allow them to partner with us to help program beneficiaries live healthy, fulfilling lives as independently as possible.

“This administration stands for a policy that makes Medicaid a path out of poverty. ... We owe it to these Americans to try whatever may help them achieve the dignity and self-sufficiency they deserve,” Verma wrote.

Greg Lawson, a research fellow at the Buckeye Institute, said work requirements get more people involved in work or some sort of job training, education or volunteer activity.

“This is a ladder out of long-term poverty for those who are largely able-bodied adults ... and keeps people going in the right direction,” he said.

Some liberals and consumer advocates argue that studies show that most Medicaid recipients already are working and rely on Medicaid because their employers don’t offer coverage.

“Work requirements are redundant and unnecessary because most people are working. The problem is there aren’t enough well-paying jobs,” said Wendy Patton, senior project director with Policy Matters Ohio.

According to the Kaiser Family Foundation, 60 percent of non-elderly adults covered by Medicaid nationwide in 2016 were working in partor full-time jobs. More than a third of those not working reported they were ill or disabled, another third were caring for family members and 15 percent were in school. About 6 percent said they were unable to find work.

Patton said that in Ohio, 61 percent of working-age Medicaid enrollees are working: 40 percent full time and 21 percent part time. Most of the rest, she said, are ill or disabled, in school, caring for someone or looking for work.

Work requirements can trip up low-wage workers because their hours often fluctuate. Those in jobs such as fast-food, retail and landscaping might have changing or seasonal hours, and under the proposed employment policy, workers who don’t get enough hours lose Medicaid coverage, making it harder to stay healthy and employed.

“This policy will end up kicking people out of medical care and making it harder for them to work, not easier,” Patton said.

Kentucky’s GOP-led administration predicts that its Medicaid work requirements will reduce enrollment by 95,000; a lawsuit is challenging the requirements.

Loren Anthes, a public-policy fellow for the Center for Community Solutions, said in a recent report that based on Ohio’s experience with work requirements for welfare and food stamps, plus Kentucky’s projection about its plan, the proposal would lead to many Ohioans dropping off the Medicaid rolls — not because they gained private insurance but because they failed to comply with the new rules.

“Many enrollees likely will lose coverage due to administrative complexity,” he said.

Details of Ohio’s proposal have not been released. State officials say they are working on the request, but based on earlier comments, it is expected to be submitted early this year.

Medicaid is a tax-funded healthinsurance program for the poor and disabled administered by states within federal guidelines. More than 1 in 4 Ohioans is enrolled in Medicaid, which pays for 70 percent of nursing-home costs in the state and more than half of all births.

Lingering anger over Medicaid expansion prompted majority Republicans to add work requirements to last year’s state budget.