Governors and conservative legislators in nearly a dozen Republican-dominated states are looking to link work requirements to a Medicaid expansion under Obamacare in a bid to make the federal healthcare law more politically palatable.
According to
Politico, the Obama administration has ruled out the possibility of adding a work requirement, believing it will undermine the objective of ensuring universal health coverage to low-income Americans.
"This is supposed to be an incentive and encouragement for people to work versus an incentive for people to just receive the government benefit and not be part of a working culture of Arkansas," Gov. Asa Hutchinson told Politico.
The move is being taken up in Indiana, Florida, Utah and at least eight other states dominated by the GOP as a way of offsetting the cost of the expansion and reducing the risks of fraud and abuse. Lawmakers are considering a range of options from requiring employment to job hunting or job training.
"I wanted to be able to say, 'if you want the taxpayers to fund your healthcare, then you need to go out and be involved in a work program, no ifs, ands, or buts.' I've been accused by the Obama administration: 'Well, you're trying to turn this healthcare program into a work program.' And I've said, 'You're right,' " Utah Gov. Gary Herbert told Politico.
The administration is flatly opposed to any moves that would link the federal healthcare law to work, believing the Medicaid expansion should not be viewed as a welfare program.
The administration "has proven its willingness to work with governors of both parties" to connect Medicaid expansion recipients to state-run employment programs on a voluntary basis, Obama's Medicaid Director Vikki Wachino said in a statement to Politico.
But, Wachino added, "because Medicaid is a health coverage program, requiring employment may not be a condition of eligibility."
Congressional Republicans are also looking for ways to link Obamacare to work.
Arkansas Rep. Bruce Westerman introduced a bill to pave the way for states to introduce work requirements without first having to seek permission from the federal government.
A 2014 Kaiser Family Foundation study found that 57 percent of potential Medicaid recipients already work, according to Politico. Of those who do not, roughly a third are providing care for family while 20 percent were looking for work and 17 percent were mentally ill or disabled.
One former government official who ran Medicaid for the Obama administration insists that making benefits contingent on work undermines the purpose of the Affordable Care Act.
"You're going to have gaps in coverage," Cindy Mann, a partner at the Manatt healthcare consulting firm, told Politico. "You're going to defeat those goals of improving health."
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