State health Secretary Lee Norman on Tuesday warned lawmakers that adding a work requirement for Medicaid expansion could drive up the cost of the program.
A work requirement, he said, could create a large amount of churn within the Medicaid program and increase costs for tracking beneficiaries moving in and out of the program that serves the less affluent.
Norman warned that a work requirement as well as drug testing and lockouts for not paying premiums could mean the state would need more resources to deal with an increase in applications.
Norman said he is concerned about potential gaps in health coverage as people enter and leave the program either for not complying with a work requirement or not paying their premiums and getting locked out of the program.
“I worry about gaps in coverage, because that’s not good for people’s health.”
Norman, the secretary for the Kansas Department of Health and Environment, stressed that he wasn’t making a political statement as much as he was addressing how his agency would have to respond to additional requirements for expansion.
Last week, an interim legislative committee studying Medicaid expansion recommended a work requirement for Medicaid expansion.
The recommendation doesn’t have the power of law, but it does give some sense about what conservative lawmakers are thinking going into next session.
Supporters of work requirements believe public assistance should encourage employment.
Critics say work requirements don’t improve public health and are designed to remove people from the program.
Republican state Rep. Brenda Landwehr encouraged Norman to find creative ideas for encouraging beneficiaries to work.
She said a training component needs to be available to the Medicaid population.
“When we’re looking at the work requirement, from most our perspectives, it’s not a punishment, it’s an incentive, ” Landwehr said.
“How could we make that smoother and still get the same result of trying to give people that hand up instead of hand down?” she said. “I think most people want a hand up.”
So far, the Legislature has not been asked to consider a work requirement.
The bill passed earlier this year by the Kansas House does not contain a work requirement, and neither does the bill that will likely be a starting point for debate in the Senate next year.
Norman’s comments reflect the second time in a week that a member of Gov. Laura Kelly’s administration has challenged Republican ideas about Medicaid expansion.
Last week, the governor’s budget director told the joint Medicaid committee that he couldn’t reliably assess the cost of the Senate’s Medicaid plan.
Almost 20 states have tried to adopt work requirements for Medicaid expansion. Arizona and Indiana recently suspended those rules.
A federal judge has already blocked work requirements in Arkansas, Kentucky and New Hampshire because the federal government didn’t consider how the rules would affect the primary goal of Medicaid — to provide coverage to the poor.
Last month, a federal appeals court heard arguments on the work requirements.
The appeals court judges also questioned whether the work requirements violated the objective of the Medicaid program to provide medical coverage to the needy.
