Medicaid recipients say they need health care to work

Medicaid recipients in Maine told state regulators Wednesday they shouldn't be forced to work to continue getting their health care benefits as the Republican governor has proposed.

The health care bill recently approved by U.S. House Republicans would let states require certain Medicaid enrollees to work — an unprecedented change to the half-century-old health care program for low-income people run by states. The Senate is considering the bill.

In Maine, Gov. Paul LePage's administration wants to require most "able-bodied" adults to work, volunteer or take classes if they receive MaineCare benefits. The governor's office contends those and other adjustments would likely decrease the number of Mainers participating in the program and generate $8 million annually.

About 270,000 residents receive MaineCare, most of them children, the elderly, people with disabilities and low-income parents.

"The program has grown well beyond that, and often to the detriment of those core populations," said state Department of Health and Human Services Commissioner Mary Mayhew, who said work boosts self-esteem.

The administration wants to help able-bodied adults get "out of poverty and access good-paying jobs with benefits," Mayhew said.

Welfare reform is a cornerstone of LePage's administration, which has imposed work requirements for food stamps and successfully cut thousands of childless adults from MaineCare.

The administration also wants MaineCare recipients to pay $20 co-pays for "non-emergency" emergency room visits and fees assessed by providers for missed doctor's appointments.

Mayhew said her department will explore ways the state can help Medicaid enrollees prepare for and find jobs. New Hampshire refers Medicaid adults to job counseling services, while the federal government hasn't yet approved any waivers from states requesting work requirements for Medicaid.

"We expect, however, that in this new administration, that they will be much more receptive to these proposals," Maryhew said.

MaryBeth Musumeci, associate director of the Kaiser Family Foundation's program on Medicaid and the uninsured, said her research shows that nationwide, nearly 8 in 10 Medicaid adults without disabilities already are in working families, with 59 percent working themselves.

"One issue is that many of these Medicaid adults are working in low-paid jobs that don't offer employer-sponsored coverage," she said.

At a Wednesday public hearing in Portland, opponents said the rules would target low-income families who struggle with generational poverty, health issues, childcare costs and varying requirements for public assistance programs.

"You can't tell me that me and my family haven't been working hard," said Elizabeth Capone-Henriquez of Portland, who said she turned to MaineCare because past jobs didn't provide health care.

Old Orchard Beach resident Judy Bullard said Medicare covers $600 of her monthly supply of epilepsy medication, while MaineCare covers the remaining $1,100.

Maine's proposal exempts those receiving disability benefits and would require medical certification if it's "not evident" that an individual is physically or mentally unable to work.

"It took me a long time to get on disability and if I had lost health care, work would have been out of the question," Bullard said. "I would have been very sick or even dead. The idea that a caseworker could make a determination about my ability to work by looking at me and talking to me is terrifying."

She said that it's unfair to punish people for missing doctor's appointments for "reasons out of their control," such as falling ill or mishaps with MaineCare transportation providers.