Gov. John Bel Edwards is working on a proposal to require able-bodied Medicaid recipients to work to continue receiving benefits.

This is a populist effort that has political appeal, but it isn’t much of a reform.

First, a huge percentage of the people on Medicaid are already working.

The working poor, so named because they have jobs but still cannot afford medical coverage for themselves and their families, are not shirking their responsibility to work. Instead, they are embracing work. But even as they do, they require the assistance that Medicaid offers.

According to the state’s estimates, as much as 75 percent of the state’s 1.6 million Medicaid recipients fall into this category. And their ranks have swollen in the past several years as the Medicaid expansion extended the benefit to nearly a half-million people who before were ineligible because of the income requirement.

It is worth noting that expanding Medicaid coverage to so many has actually saved the state money and will likely continue to do so. The federal government paying a higher portion of medical expenses for these working poor. And, by being covered, these people are more likely to seek preventive care, something that should reduce costs and improve outcomes over time. They are also more likely to see doctors than to seek treatment in emergency rooms – another side-effect that lowers costs.

On top of the as much as 75 percent who are already working, another 20 percent of the current Medicaid recipients would be exempt from the requirement by some of the proposals. People who have disabilities or who are pregnant, caring for infants or are in drug treatment programs would probably be exempt.

So that leaves 5 percent or 10 percent of Medicaid recipients who could be subjected to a work mandate. Meanwhile, many times more than that will have to submit paperwork and go through other burdensome bureaucracy to satisfy the proposed requirement.

And on the state’s side of the equation, enforcing such a requirement on so many people will surely take more government workers. The cost of expanding the state’s workforce must be weighed against any reasonably foreseeable benefit to imposing the new requirement.

It could be that the governor and Legislature can work together to craft a work requirement that can be imposed without unjustifiably large costs in exchange for dubious benefits.

 

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