Idaho Gov. Brad Little signed a bill into law Tuesday to obligate certain Medicaid beneficiaries under Obamacare work as a condition of receiving government healthcare.
“We must encourage self-sufficiency among those receiving public assistance,” Little, a Republican, wrote in a letter outlining his approval of the bill.
State lawmakers passed the program, known as work or “community engagement” requirements, despite a federal judge’s ruling last month to halt similar programs in Arkansas and Kentucky and despite voters approving the full expansion during the midterm elections. Work requirements, which obligate people to work, volunteer, or take classes, result in people being booted from Medicaid and lower overall enrollment.
Little admitted in his letter approving the bill that the lawsuits in other states were a concern and that he was worried about people being able to report their hours to Idaho’s agencies. In Arkansas, more than 18,000 people were dropped from Medicaid after they failed to work or failed to log that they had worked.
Other states in which voters approved Obamacare’s Medicaid expansion have seen state lawmakers pare back the expansion, including in Utah. In Nebraska, for instance, the state will delay an expansion approved by voters. The latest actions in Idaho underscore that ballot measures are not necessarily the final say in states where lawmakers are not supportive of funding expanded Medicaid outright.
States are not allowed to implement work requirements without first getting approval from the Trump administration. Federal officials appeared to show they are undeterred by adverse court rulings after the administrator for the Centers for Medicare and Medicaid Services, Seema Verma, signed off on a work requirement in Utah.
In states that have the work programs, low-income people on Medicaid who are not disabled and are of working age can be asked to work or train for work for 80 hours a month as a condition of being allowed to remain in Medicaid.
The Trump administration has approved work rules in states because it opposes the changes Obamacare made to Medicaid. As the healthcare law was originally written, all states were set to expand Medicaid coverage, which is mostly funded by the federal government, to people making under the $17,000 a year income threshold, regardless of other factors, such as disability or employment status.
A Supreme Court decision made the provision optional, so roughly a dozen states haven’t yet expanded. Others have looked to make alterations to the program rather than expand it as written.
Officials from the Trump administration have said that coverage should not extend to adults capable of work and instead should be limited to the most vulnerable groups, such as people with disabilities, children, and older adults who need specialized care.
