The good news is that low-income households in a state with a Republican governor and a Republican legislature will now have the opportunity to get health care coverage under an expanded Medicaid program because state officials have dropped their insistence on a work requirement for all those who benefit.
The bad news is that state was not Utah.
Pennsylvania Gov. Tom Corbett Thursday struck the deal with the U. S. Department of Health and Human Services that will allow the Keystone State to expand Medicaid coverage to an estimated 300,000 people, as envisioned by the original Affordable Care Act, but with a couple of wrinkles that will allow Corbett a little pride of authorship.
The administration will allow Corbett to charge recipients who live above the poverty line a small — no more than 2 percent of income — premium, and to base rates and costs partly on recipients’ healthy, or not so, lifestyles.
But the White House did not budge on Corbett’s desire to require Medicaid recipients to be working, actively looking for work or be engaged in work training. The administration says the requirement would be illegal, and would go against the whole idea of the ACA, which is to make health care accessible to every American, regardless of circumstances.
Such a work requirement is exactly what Utah Gov. Gary Herbert wants to add to his Healthy Utah version of Medicaid expansion. And it is, Herbert said Thursday, the final stumbling block in his negotiations with HHS.
David Patton, head of the Utah Department of Health, told the Legislature’s Health Reform Task Force Thursday that Herbert doesn’t want to abandon that point. But that he might if he can be convinced that it really is illegal.
The Pennsylvania experience should give Herbert the political cover to conclude that his work requirement is indeed a deal-killer and abandon it. He has already granted, with refreshing honesty, that the requirement is more symbolic than practical. The vast majority of people who would be covered through Healthy Utah either work already or would qualify as disabled.
But it would also add paperwork, review time and other burdens, both to the state and the people who need coverage.
Corbett may have caved because he is facing a tough re-election fight from a Democrat. Herbert may be reticent to concede because any challenge to his political future will most likely come from his right.
But Herbert’s devotion to a politically symbolic statement continues to leave as many as 77,000 Utahns without access to affordable health care.
It’s not the poor who are shirking work here. It’s the governor who is failing to get the job done if he insists on keeping the requirement.
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