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Fallin orders Medicaid work requirement; details unclear

Gov. Mary Fallin

Gov. Mary Fallin

Oklahoma City — Gov. Mary Fallin signed an executive order Tuesday ordering the state Medicaid agency to try to add a work requirement, but it appears to affect only 1 percent of recipients.

The order requires the Oklahoma Health Care Authority to seek a waiver allowing it to add a work requirement to the Medicaid program in the next six months.

All waivers must go through the Centers for Medicare and Medicaid Services. Under previous administrations, adding a work requirement was a no-go, but Indiana, Kentucky and Arkansas have gotten permission to add one under President Donald Trump.

The Medicaid work requirements have existed for only a few months, so it's impossible to point to a track record of how they affected recipients.

Fallin proposed that requirement exempt people younger than 19 and older than 64; pregnant women; people caring for a child younger than six, or children older than six with a “serious medical condition” or disability; adults complying with unemployment insurance requirements; people “medically certified” as physically or mentally unfit for work; and people in a drug or alcohol rehabilitation program.

The health care authority estimated about 8,000 current members, out of 798,013 total, don't fall under one of the exemptions, but said it would continue to analyze the impact of a work requirement.

The exemptions don't define a serious medical condition or how medical certification would work, though it's possible the health care authority could provide more details in its waiver application. Fallin's order also didn't outline how many hours a person would have to work to remain eligible, or whether work-related activities like pursuing job training would count toward the requirement. It also isn't clear if recipients have a grace period if they lose a job.

In a news release accompanying her executive order, Fallin said a work requirement would encourage recipients to reach economic independence.

“We in Oklahoma should require people who receive Medicaid assistance to work, if they are able,” she said in the release. “A core objective of the Medicaid program is to help low-income families and individuals attain capability for independence. Work requirements in other welfare programs have helped move individuals from welfare to work.”

Carly Putnam, an analyst at the left-leaning Oklahoma Policy Institute, said it might actually do the opposite. Parents might have to give up on pursuing their education to take a minimum-wage job, she said, or lose access to services that make them healthy enough to work.

“None of these people are going to be more employable if they lose access to their inhalers,” she said.

Meg Wingerter

Meg Wingerter has covered health at The Oklahoman since July 2017. Previously, she lived in Topeka, Kansas, and worked at Kansas News Service and The Topeka Capital-Journal, where she earned awards for business coverage. She graduated from... Read more ›