Analysis: Edwards Proposing Medicaid Idea Championed By GOP

BATON ROUGE, La. (AP) — Gov. John Bel Edwards' announcement that he intends to pursue work requirements for some Medicaid recipients in Louisiana seemed to catch Republicans who have championed the idea by surprise.

They want to make sure the Democratic governor follows through on the proposal they've pushed unsuccessfully — and that he doesn't get all the credit.

Many question marks remain about what exactly Edwards wants to enact, what process he'll use and how many low-income people would be impacted in Louisiana's $12.5 billion Medicaid program. It's unclear how long it will take the Edwards administration to develop something that could be submitted for federal approval.

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In response to questions after a Jan. 8 speech, Edwards said his administration is "actively working" on the concept. It turned out to be a timely comment, coming days before President Donald Trump's administration announced it will allow states to enact such work requirements for able-bodied, working-age Medicaid recipients.

The governor's comment was unexpected. Edwards administration officials with the state health department previously expressed concern about similar suggestions, such as when Sen. Sharon Hewitt, a Slidell Republican, proposed the idea last year.

Hewitt is calling on Edwards to support her legislation.

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"Providing citizens with additional education or training they need to secure a job can lift them out of poverty and onto a path to improved health outcomes," Hewitt wrote in a newspaper letter.

Republican U.S. Sen. John Kennedy also has pushed work requirements for years. He's called on Edwards to submit a waiver quickly.

In Louisiana, Medicaid covers 1.6 million people, one-third of the state population. That includes newborns, pregnant women, elderly nursing home residents, people with developmental disabilities and more than 450,000 working-age adults through the Medicaid expansion.

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Any work requirements would fall mainly on the expansion population. Edwards said a majority of people receiving government-financed insurance through the expansion already have jobs. Others, he said, are in school, are sick or are caring for family members.

"For those who are not currently working but are able and eligible to work, we must find reasonable ways to ensure they, too, benefit from the dignity of being employed," Edwards said.

Critics of work requirements tend to be Edwards' allies who say the restrictions can penalize poor people who may be unable to find employment and could lose life-saving health insurance.

Jeanie Donovan, with the Louisiana Budget Project, which advocates for low- to moderate-income families, said the requirements could add new state bureaucracy to check employment and put people at risk of losing coverage because of an administrative mistake. She said it would drive up health care costs elsewhere if people are bumped from their Medicaid coverage.

"While the idea of a work requirement may sound good to some, the reality is that it would take away health coverage, create more red tape and make it harder for many people who want to work to find employment," Donovan wrote.

Details of what the Edwards administration is developing are scant.

Edwards said he wants the work requirements to include exceptions for people in school or training programs, and he suggested volunteering could take the place of work. The governor's office didn't say whether Edwards would seek legislative approval before submitting the request to federal officials.

While Edwards said Louisiana was "working with the same consulting firm that worked with Kentucky" on its waiver approved this month by federal officials, no contract has been signed.

Kennedy appears to be skeptical about whether Edwards is sincere about the proposal. The senator sent a letter Tuesday to Edwards, offering to set up a meeting with federal Medicaid administrator Seema Verma "to help expedite" the waiver request.

"Louisiana needs to have a proposal on the table well before Easter," Kennedy wrote.

Edwards replied by saying he told Health Secretary Rebekah Gee last year to start developing requirements for work, education or training as "a key component to the successful expansion of Medicaid." He said Gee already has a meeting scheduled with Verma.

"This requirement needs to be carefully considered and not just designed in a way to score political points," Edwards wrote. "That is the course I will continue to pursue."

-By Melinda Deslatte, Associated Press

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