Landry says Medicaid work requirements, copayments are under consideration

26th December 2023   ·   0 Comments

By Julie O’Donoghue
Contributing Writer

(lailluminator.com) — Gov.-elect Jeff Landry is considering work requirements and copayments for enrollees in Louisiana’s Medicaid program. The proposals tend to be popular with Republicans but controversial in the health care sector.

“We are working to take people from dependence to independence,” Landry said during a press conference Wednesday at the University of Louisiana at Monroe, when asked about possible work requirements and co-payments.

“The more freedom you give a person, the more opportunity you give them to work, the more they are able to implore their labor, the more rewarding that individual is,” he said. “Quite frankly, it’s why you see elderly people who continue to work way past their 70s and into their 80s.”

“So I would tell you we are going to have everything on the table,” he said.

Medicaid work requirements typically compel able-bodied adults to have a job, volunteer or enroll in school in exchange for coverage. Copayments are a form of costing-sharing for health care plans. Under such a proposal, Medicaid recipients would be responsible for paying a portion of their health care bill. during medical visits.

Democrats and public health advocates have questioned whether Medicaid work requirements really achieve their stated purpose of encouraging people to get jobs.

Most Medicaid recipients in Louisiana are children. Thousands of others have disabilities that make it impossible to hold a job. Low-income people enrolled in Medicaid are often already employed; they just don’t earn enough money to be able to afford private insurance.

“Certainly, I would hope that is not the plan because we know that work requirements don’t work,” said Jan Moller, head of the Louisiana Budget Project, a left-leaning organization that advocates for low-income people. “It puts another hurdle in front of people who simply want to go to see a doctor when they are sick.”

At the behest of Republican state lawmakers, Louisiana briefly looked at implementing work requirements for Medicaid in 2018 but quickly abandoned the proposal when it appeared a work mandate might cost the state more money than it saved.

At the time, state health officials said the edict would require them to build out an entirely new bureaucracy. Louisiana would then have to hire more state workers and invest in new technology to track whether Medicaid recipients were complying with the proposed work demands.

Republican and Democratic state legislators also grew concerned the work requirement would create an additional barrier to enrollment and inadvertently kick people out of Medicaid who should still be eligible.

When Arkansas briefly installed work requirements in 2018, thousands of people were dropped from Medicaid, in part because they didn’t fill out paperwork properly. Eventually, a federal judge directed Arkansas to throw out its work mandate altogether.

“Data from Arkansas suggests that these requirements were confusing to enrollees and result in substantial coverage loss, including among eligible individuals,” wrote Madeline Guth and MaryBeth Musumeci for KFF, a health care policy think tank, in 2022.

In Georgia, Republican Gov. Brian Kemp has also struggled to get a Medicaid program tied to work off the ground this year. Only 1,300 people have signed up for coverage after three months, even though the Kemp administration had projected enrollment would reach as high as 100,000, according to the Associated Press.

Copayments for Medicaid enrollees also tend to see tremendous pushback from hospitals and other medical providers.

People on Medicaid are, by definition, low-income or living with a disability. They often can’t afford to cover a portion of their bill out of pocket. Hospital and doctors often lose out on money when Medicaid patients are asked to pay for part of their services, health care providers have said.

“We’ve always been against co-payments,” said Randy Morris, chairman of Louisiana’s Rural Hospital Coalition and owner of West Carroll Health Systems.

Landry takes over from Democratic Gov. John Bel Edwards Jan. 8.

This article originally published in the December 18, 2023 print edition of The Louisiana Weekly newspaper.