Deep Divisions Surface Over Medicaid Work Requirement

Shauna Reitmeier sat at a Minnesota Senate committee table telling lawmakers the bill they were considering would hurt mentally ill patients she serves.

Sitting inches to her right Thursday, March 29, was Sen. Mark Johnson, author of the bill she pleaded that senators defeat. It would require some able-bodied people to work if they receive government-funded health care.

“An arbitrary line is being drawn about who is worthy and who is not worthy of getting health care,” said Reitmeier, CEO of Crookston-based Northwestern Mental Health Center. She said the bill, if it becomes law, would “add anxiety and stress” to mental health patients.

Northwestern is the only comprehensive mental health center in Johnson’s district.

Johnson, R-East Grand Forks, said after the health and human services committee voted 7-6 in favor of his bill that he will work on clarifying issues related to the mentally ill before its next committee stop and a full Senate vote.

The bill drew emotional testimony from about two dozen people, all but one opposing it. Testimony came from witnesses, such as a veteran who said, “I was willing to protect my country, now I am asking you to protect me,” and county officials who said they would have to add hundreds of people to handle paperwork Johnson’s legislation would cause.

In the end, the Republican majority won the narrow vote, although Sen. Scott Jensen, R-Chaska, abstained. He is a medical doctor who said the legislation is “part of the journey” to improve health care, but he could not accept it as is.

Johnson’s bill, similar to what Republicans long have discussed, would require many able-bodied people receiving Medicaid, known in Minnesota as Medical Assistance, to work unless they are students, pregnant, care for dependents at home or have health problems. Also not being forced to work would be people 18 and younger and 60 and older, those who already are working 30 hours a week or are enrolled in a substance abuse treatment program.

If a person is not working and cannot find a job, community service could be substituted. People actively looking for work also could be exempted from the work requirement.

The Department of Human Services estimates that 74,000 would need to find jobs.

The department also says that, within two years, it would have to add 65 people to deal with paperwork Johnson’s bill would create, not counting the hundreds county officials say they would need.

Johnson’s bill could cost the state up to $7 million more by 2021, the department says, which does not include added county costs.

Although Republicans often say that putting people to work would save the state money, Johnson said that was never his goal. He said that getting people to work was why he introduced the legislation.

Democratic Gov. Mark Dayton is expected to veto the bill if it reaches his desk as standalone legislation. However, if it arrives folded into a bigger bill with provisions he supports, it is not known how he will react.

This week, Dayton wrote to lawmakers about their work bills, saying he “strongly” opposes such bills because they would deny health care to poor Minnesotans.

“Since it became law over 50 years ago, Medicaid has shown that access to health care improves people’s lives and our economy,” Dayton wrote. “Medical Assistance creates pathways out of poverty for people with disabilities, those with low incomes, and many older adults. It also covers over 40 percent of Minnesota’s children.”

Johnson said his bill would increase Minnesota’s workforce at a time when many employers report they cannot find enough workers.

“I have been here 31 years and have never seen us try to take away Medical Assistance,” Sen. John Marty, D-Roseville, said.

Sen. Tony Lourey, D-Kerrick, went to Johnson before the meeting and warned that the bill would face strong opposition. “This is a really bad one.”

Johnson told fellow senators about a neighbor who was born with significant medical issues and received Medical Assistance. Now, he said, she is doing well and is a success in her work.

Johnson said he wants others to have the same chance.

“This bill is narrowly tailored,” he said, to get healthy adults into jobs.

Some people, he said, “may need a little extra incentive” to get off Medical Assistance.