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Stewart: The people have spoken: Medicaid ‘work requirements’ won’t work for Virginia

Published by The Roanoke Times

By Maani Stewart

Stewart is National Training & Consumer Education Manager for Young Invincibles, a group founded to provide a voice for young adults in the health care debate.

Earlier this year, millions of Virginians celebrated as the state legislature and Gov. Ralph Northam worked together to expand Medicaid. This historic progress for our state means that as of this month, as many as 400,000 low-income Virginians can begin enrolling in new health coverage. For this first time, many folks across the state will be able to access affordable primary care, emergency room visits, maternity care, and more.

However, an unfair provision included in the final expansion agreement threatens to undermine this tremendous progress and deny coverage thousands of these hardworking Virginians. Lawmakers included a new, punitive provision that many Medicaid enrollees must prove that they work a certain number of hours per month to keep their basic health care.

These “work requirements” are a solution in search of a problem that does nothing more than block Virginians who need it most from getting access to affordable care.

That’s why it is not surprising that we’ve seen an outpouring of opposition to Medicaid work requirements from folks across the state in recent weeks.

The numbers speak for themselves: in all, 1,832 Virginians submitted comments about the proposal to expand Medicaid with work requirements to the Virginia Department of Medical Assistance Services. Only three comments supported instituting work requirements. That’s less than 0.2 percent.

That’s because Virginians know these restrictive work requirements would be devastating for those who already face the highest barriers to quality health care.

It is important to understand that many Medicaid enrollees have nowhere else to turn for health coverage. To even qualify for Medicaid, a single adult must make less than $17,000 a year. In some parts of the state, that’s less than half of what’s needed to afford basic annual living expenses such as housing, food, transportation, and taxes. With an income of barely $1,400 per month, there’s just not a lot leftover to pay for additional insurance premiums once Medicaid is taken away.

The notion of work requirements are advanced by politicians under the false claim that Medicaid enrollees are choosing not to work, and that imposing the programs would incentivize work. That is simply not true.

The majority of Medicaid recipients who are able to work are already working. Most of those who aren’t working live with an illness or disability, are taking care of a family member, or are attending school. Moreover, work requirements do not improve employment rates. The Center on Budget and Policy Priorities found that over a five-year period, there is little difference in employment rates between public assistance households that are subject to work-requirements versus those that are not. With an estimated price tag of over $20 million for Virginia taxpayers, work requirements would be wasted money on a misguided solution to a problem that doesn’t exist.

Moreover, the risk of losing health insurance because of work requirements goes beyond those unable to work. The administrative burden placed upon those that already work to verify their employment will also lead to coverage losses. Thousands of Virginians could lose their health coverage not because they aren’t working, but because they cannot navigate the maze of bureaucratic red tape to document, verify, and report their hours worked every month.

The end result of these work requirements would be an estimated 26,000 Virginians immediately losing their health insurance, with thousands more at risk of losing coverage in the future. This impact would be of particular concern for communities of color as it would disproportionately minorities and further deepen already existing health inequities. For instance, Young Invincibles estimates that while African Americans make up 19 percent of the young adult population in Virginia, they account for 34 percent of young Medicaid enrollees.

For the 255,000 young adults who are currently enrolled in Medicaid or will become eligible with the expansion, access to health care is an essential lifeline. That’s why so many Virginians have spoken out in opposition to these harmful “requirements” and why Young Invincibles is joining them to defend coverage for our fellow Virginians.

Lawmakers should heed the will of the people and deliver on the full promise of Medicaid expansion, without work requirements that harm the very people Medicaid expansion should help.