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Medicaid Work Requirements Clear First House Panel

A doctor is sharing health information with their patient

Florida lawmakers are one step closer to adding a work requirement for Medicaid eligibility. 

The measure (HB 955) cleared the House Health Market reform committee 8-4 on party lines, despite opposition from health advocates and Democrats.

It would add the same work requirements currently in place for Florida’s Temporary Cash Assistance Program (TCA) to Medicaid participants.

TCA is a program that helps low-income families get back on their feet while remaining in their own homes.

Enrollees would have to show proof of employment to the state Department of Children and Families, and would be required to work no more than 40 hours per week. The work requirement would be satisified by:

  • Unsubsidized employment
  • Subsidized private sector or public sector employment
  • On-the-job training
  • Community service programs
  • Work experience
  • Job search and job readiness assistance
  • Vocational educational training
  • Job skills training directly related to employment
  • Education directly related to employment
  • Satisfactory attendance at a secondary school or in a course of study leading to a high school equivalency diploma
  • Providing child care services

The requirement applies to people with children older than three months and those without children ages 19 and 20.
Those receiving Supplemental Security Income, Social Security Disability Insurance or who do not meet federal work eligibility requirements are exempt.

The bill’s sponsor, Rep. Daniel Perez (R-Miami), said it would only apply to about 8 percent of those on Medicaid.

"The people that we’re going to try and implement this on [are] individuals who are a able-bodied adults that can go out into the workforce and be responsible," Perez said.

Karen Woodall, executive director of the Florida Center for Fiscal and Economic Policy, pushed back. She said to qualify for Medicaid, parents are only allowed to earn up to 31 percent of the federal povery level in wages.

"So if parents are required to go out in work, there is a huge disincentive to making anything because they’ll lose their health insurance," Woodall said. "And I would submit not having health insurance is not a way to help get people out of poverty.”

Matt Jordan, Florida government relations director for the American Cancer Society, worries the requirements could jeopardize treatment for cancer patients.

“It is a very debilitating disease and there are a lot of side effects that go along with cancer," Jordan said. "A lot of those side effects will keep people from being able to work. A lot of doctors actually recommend you stay home and not work while you’re battling cancer.”

Rep. Nicholas Duran (D-Miami) said the bill targets parents. He said he appreciates the bill’s intent, and would be willing to work on with Perez if Florida had expanded Medicaid under the Affordable Care Act. 

“We’re not expanding the program; we’re just focusing in on a very limited group of people," Duran said. "And I don’t think it works toward what believe are working to do here.”

Lawmakers this session are weighing proposals to expand acess to health care, a priority of House Speaker Jose Oliva. Rep. Margaret Good (D-Sarasota) agrees there is a need for greater access. However, Good said this measure would do the opposite.

"What it seems like we would be doing here, if this bill were to pass," Good said, "is to create further barriers so that people remain sick and remain poor, and don’t have the access to health care they need to get out of that hole.”

Yet Perez fought off criticism. He said the requirements are not meant to be a burden.

“We take into consideration that there may be a child at home," Perez said. "We take into consideration the potential transportation problems. And that’s why the amount is less than a fulltime job for each individual.”

If signed into law, the measure would be subject to federal approval before taking affect.

Sen. Dennis Baxley (R-Lady Lake) is sponsoring a similar bill in the Senate. But that measure (SB 1634) would also impose stricter penalties on people who fail to meet the work requirements for Temporary Cash Assistance. It has not yet been heard. 

Shawn Mulcahy is a reporter and All Things Considered host for WFSU. He graduated from Florida State University in 2019 with majors in public relations and political science. He was previously an intern at WFSU, and worked as an Account Coordinator at RB Oppenheim Associates.