This spring, despite robust advocacy efforts from our partners at the Tennessee Justice Center and a strong coalition, Tennessee passed a law directing TennCare, the state’s Medicaid program, to impose “reasonable” work requirements on able-bodied adult enrollees without children under the age of 6. Tennessee passed the measure after the Trump administration issued a new policy in January 2018 inviting states to create work requirements for their Medicaid programs. A Better Balance submitted comments to TennCare last week expressing our strong opposition to these unnecessary and unjust requirements. If allowed to go into effect, they will harm the health and economic stability of thousands of Tennesseans by putting their health coverage at risk and by undermining Medicaid’s vital role as a safety net for vulnerable low-income people in the state.
The majority of Medicaid recipients in Tennessee are already working either full-time or part-time, and the majority of those who are not working are either ill, disabled, or are caring for a child or family member. Some of these people may be exempted from work requirements, but burdensome verification processes and other practical barriers are very likely to lead to “exempted” beneficiaries losing coverage, not because they are ineligible, but because they are unable to provide the necessary documentation.
Those hardest hit will likely be Tennesseans with chronic health conditions (who are expected to make up a large fraction of those affected), for whom gaps in access to treatment and medications can be catastrophic. Moreover, losing health care coverage can lead people to delay or forego care, particularly essential preventive care, and to rely on emergency rooms for costly care.
Medicaid recipients who can and do work are also at risk of losing health care coverage, since low-wage workers are more likely to be underemployed and to face unpredictable work schedules over which they often have no control. This is just one of the challenges that many of ABB’s clients and others like them already face in balancing work and their responsibilities in caring for children and other family members. Rather than doing anything to alleviate these problems and enable these people to work to their full potential, these requirements will add an unnecessary burden to the lives of working families and are likely to leave many such families without essential health coverage.
We are hopeful that our comments and those submitted by our partners and other advocates in Tennessee will convince policymakers to reconsider these work requirements. A Better Balance remains committed to advocating for policies that will allow Tennesseans at all income levels to care for themselves and their families without sacrificing their economic security.