Mississippi is seeking federal permission to require job training for some able-bodied adults who receive Medicaid, and the Trump administration has signaled that is open to approving such plans.
Medicaid is a health insurance program paid by federal and state money. It covers the needy, aged, blind and disabled, and low-income families with children.
Mississippi is one of the poorest states in the nation, and nearly 706,000 of the state’s residents were enrolled in Medicaid last month — about 24 percent of its population.
About 15,000 to 20,000 low-income parents or caregiver relatives could be affected by the job training mandate if the federal government approves the state’s proposal, said Erin Barham, spokeswoman for the Mississippi Division of Medicaid.
The low-income parent or caregiver relative category includes more than 56,000 people, but Barham said the state’s proposal would exempt some from the job training requirement, such as people diagnosed with a mental illness and full-time caregivers for a person who cannot care for himself or herself.
The state’s application says the training could reduce Medicaid expenses by helping people find jobs with health coverage.
“We believe the initiatives outlined in this application will assist us in ensuring the viability of the Medicaid program for future generations,” the application says.
Critics say jobs are scarce in parts of Mississippi, and the plan could increase the number of uninsured residents.
Rims Barber is with the Mississippi Human Services Coalition, a private group that advocates for government social services for the poor. He said a parent who has two children and works 20 hours a week at minimum wage would earn too much for the family to receive Medicaid coverage.
“I am for people having jobs. I’m for people getting training. I’m for people getting health care. We need all those things,” Barber said Wednesday after a public hearing about the job training proposal.
“But the jobs that these people will get are typically four hours a day during the lunch hour in a restaurant that doesn’t give health insurance, it doesn’t have a retirement program, it doesn’t have any benefits that go with the job,” Barber said. “So, what are people getting that’s so wonderful? They’re getting a few bucks in their pocket, and that’s good. But it’s not much.”
Jameson Taylor is a vice president at the Mississippi Center for Public Policy, a nonprofit group that advocates limited government.
“We believe that work is the best anti-poverty program out there,” Taylor said Wednesday. “We think that work provides dignity for people. We also believe that getting on private insurance … is the ideal option for many people because outcomes on the Medicaid insurance program are so poor. You have access problems, for instance — up to one-third of primary care doctors do not accept Medicaid patients…. We believe it’s best for the patients as well as families to have this work requirement to encourage people to improve their lives, increase their income and get new skills.”
Seema Verma, administrator of the federal Centers for Medicare and Medicaid Services, said Nov. 7 in a speech to state Medicaid directors that Medicaid was designed to cover “our most vulnerable citizens” and should not be used to cover “working age, able-bodied adults.”
“One of the things that states have told us time and time again is that they want more flexibility to engage their working-age, able bodied citizens on Medicaid,” Verma said, according to the text of her speech on the CMS website. “They want to develop programs that will help them break the chains of poverty and live up to their fullest potential. We support this.”