MONROE Gov.-elect Jeff Landry is considering work requirements and payments for Louisianas Medicaid enrollees. Advances tend to be popular with Republicans but controversial in the healthcare industry.
“We’re trying to move people from dependency to independence,” Landry said at a press conference Wednesday at the University of Louisiana at Monroe, when asked about possible work requirements and co-pays.
The more freedom you give a person, the more opportunities you give them to work, the more they can pray about their work, the more rewarding the person is, he said. Frankly, that’s why you see seniors continuing to work past their 70s and 80s.
So I would tell you that we have everything on the table, he said.
Medicaid work requirements typically force able-bodied adults to work, volunteer, or enroll in school in exchange for coverage. Co-payments are a type of cost sharing in health care plans. Under such a proposal, Medicaid recipients would be responsible for paying a portion of their health care bill. during doctor visits.
Democrats and public health advocates have questioned whether Medicaid’s work requirements actually achieve their stated purpose of encouraging people to get jobs.
Most Medicaid recipients in Louisiana are children. Thousands more are injuries that make work impossible. Low-income people enrolled in Medicaid are often already working; they just don’t make enough money to afford private insurance.
“I certainly hope that’s not the plan, because we know that work requirements aren’t going to work,” said Jan Moller, director of the Louisiana Budget Project, a left-leaning organization that advocates for low-income people. “It puts another barrier in front of people who just want to see a doctor when they’re sick.”
At the behest of Republican state legislators, Louisiana briefly reviewed the implementation of Medicaid work requirements in 2018 but quickly dropped the proposal when it appeared that the work authorization might cost the state more money than it saved.
At the time, state health officials said the edict would require them to build a whole new bureaucracy. Louisiana would then have to hire more state workers and invest in new technology to track whether Medicaid recipients are complying with the proposed work requirements.
Republican and Democratic state lawmakers also worried that the work requirement would create an additional barrier to enrollment and inadvertently kick people off Medicaid who should still be eligible.
When Arkansas briefly installed job requirements in 2018, thousands of people dropped out of Medicaid in part because they didn’t fill out the paperwork properly. Finally, a federal judge ordered Arkansas to abandon its work altogether.
“Data from Arkansas suggest that these requirements confused enrollees and led to substantial coverage losses, including among eligible individuals,” wrote Madeline Guth and MaryBeth Musumeci for KFF, a health policy think tank, in 2022.
In Georgia, Republican Gov. Brian Kemp has also struggled to keep the Medicaid program tied up this year. Only 1,300 people have signed up for insurance coverage after three months, even though Kemp’s administration had estimated that the number of people signed up would reach up to 100,000. According to the Associated Press.
Payments to Medicaid applicants also face tremendous opposition from hospitals and other medical providers.
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Medicaid patients are by definition low-income or disabled. They often cannot afford to cover part of their bill out of pocket. Hospitals and doctors often lose money when Medicaid patients are asked to pay a portion of their services, health care providers have said.
We’ve always been against co-pays, said Randy Morris, president of the Louisianas Rural Hospital Coalition and owner of West Carroll Health Systems.
Earlier this year, Mississippi eliminated fees for Medicaid applicants, in part because local hospitals said they were struggling to collect money from patients.
Landry will take over from Democratic Gov. John Bel Edwards on Jan. 8.
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