IA-02: Miller-Meeks Backs Medicaid Work Requirements

State Sen. Mariannette Miller-Meeks joined 30 of her Republican colleagues this week to vote in favor of legislation requiring certain Iowa Medicaid recipients to work, volunteer or participate in a job training program in order to receive their health care benefits.

Senate File 2366 passed the GOP-controlled Senate 31-18. No Democrats voted in favor of the bill.

“I think we’re going to see a theme here of people who are going to fall through the cracks, people who are going to be denied basic assistance in their life that they should be getting, that you’re acknowledging they should be getting, because of a miscalculation in the language,” said Sen. Nate Boulton, D-Des Moines, when discussing a provision of the bill that leaves it up to the federal government to decide whether the caretaker of a disabled or elderly Iowan qualifies for an exemption to the work requirement.

“The concern here is that we’ve outsourced a major decision to the federal government that has no timeline that is at all clear for responding to whether or not someone truly is disabled and would need care as a dependent,” Boulton said.

Several Democrats took to the Senate floor Tuesday to express their reservations with the bill, including Sens. Pam Jochum of Dubuque, Joe Bolkcom of Iowa City and Rob Hogg of Cedar Rapids. No Republicans, other than the bill’s floor manager, Sen. Jason Schultz, R-Schleswig, spoke in favor of it.

In addition to work requirements legislation, Miller-Meeks, a candidate for Congress in Iowa’s 2nd District, also voted in favor of requiring felons to fully pay restitution to victims before their voting rights are restored and giving K-12 public schools an additional $85.57 million in new money for Fiscal Year 2021.

Sen. Schultz said the intent of his bill was to “help people go to work because it’s good for them. It’s good for their children, it’s good for every generation after.”

But like Boulton, other Democrats stood up to point out flaws in the legislation and how it could impact the ability of some of Iowa’s most vulnerable citizens to receive Medicaid and food stamps. A provision of the bill also gradually phases out child care assistance as a person’s income rises, rather than cutting assistance off immediately at a specific dollar amount, an issue known as the “cliff effect” that both Democrats and Republicans want to address.

The legislation’s main component, however, deals with a segment of the Medicaid population enrolled in the Iowa Health and Wellness Plan, established in response to the Affordable Care Act’s Medicaid expansion opportunities.

The bill requires able-bodied Iowans ages 19 to 64 to work, volunteer or participate in a job training program for at least 20 hours per week. Some exceptions include pregnant women, parents or caretakers responsible for a child under 6 years old or a seriously ill/disabled child; and a person participating in drug or alcohol addiction treatment; and those deemed by the Department of Human Services to be medically exempt.

“Here Republicans go again trying to create more bureaucratic hurdles, spend a lot of money on bureaucratic hurdles, to try to kick Iowans off of social service programs, in this case, Medicaid in particular,” Hogg said. “That seems mean-spirited to me, un-Iowan to me, and I don’t like it.”

According to the nonpartisan Legislative Services Agency, “While adding work requirements as a condition of eligibility does not conflict with existing federal law, other states have experienced lawsuits and legal implications after receiving approval from the Centers for Medicare and Medicaid Services (CMS) to impose community engagement or work activity requirements.”

The Iowa Hospital Association, Iowa Hunger Coalition, United Way of Central Iowa and Iowa Catholic Conference are among more than a dozen organizations registered against the bill. Conservative political advocacy groups Opportunity Solutions Project and Americans for Prosperity are the only organizations registered in support of it.

By Elizabeth Meyer
Posted 3/6/20