A new proposal to impose work requirements on Medicaid recipients in Idaho – most of whom are children or disabled – is raising concerns among health advocacy groups that had been supportive of the Idaho Health Care Plan, Idaho’s dual-waiver proposal.

The work clause, added to a new version of the dual-waiver bill introduced on Tuesday, would impose work requirements on “able-bodied” adults on the state’s Medicaid program, though the Idaho Statesman reports it’s rare for “able-bodied” adults to be allowed on Medicaid in Idaho. The state restricts the health insurance program to children in poor families, people with disabilities, poor seniors and select patients, such as those with breast or cervical cancer. Otherwise, adults only qualify if they have children and make less than 21 percent of poverty-level income, or if they’re a pregnant woman under or slightly above the poverty level.

Liz Woodruff, of Idaho Voices for Children, said, “Even if few Idahoans will be subject to these requirements, this creates additional red tape for Idahoans with disabilities and other exempting conditions to jump through to access care – resulting in additional barriers to access. Plus the bureaucracy that comes along with enforcing this across the full population could be a significant cost to the taxpayers to impact a small group of Medicaid recipients. … Our support on the IHCP is now tentative.”

Russ Barron, Idaho Health & Welfare director, said this morning when asked why the work requirement was inserted into the dual-waiver bill, "We were hearing from certain members (of the Legislature) that they were wanting these work requirements in there."

"We had been studying it since the information came out about the federal guidance," Barron said. He emphasized that the work requirement wouldn't apply to the medically frail patients who would be moved onto Medicaid under the dual-waiver plan, and also wouldn't apply to single parents of children under age 6.

Barron said the department estimates that only about 700 Idahoans on Medicaid would actually be subject to the new requirement. "It would give these people a resource to actually look for work," he said.

Statesman reporter Audrey Dutton writes that roughly 7 in 10 of Idaho’s Medicaid patients are children, and once you account for them, people with disabilities, pregnant women and other exemptions, the state counts about 15,400 “able-bodied” adults on Medicaid — just 5 percent of the state’s Medicaid population. Of those, the vast majority already have a work requirement, the Statesman reports, because they receive food stamps or are part of financial aid or child care programs. You can read Dutton’s full report here.

There were about 78,000 adults on Idaho Medicaid in fiscal year 2017, and about 223,000 children. Nationwide, the Kaiser Family Foundation says more than half of adults on Medicaid who aren’t elderly or disabled already have jobs.

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