Allison Neswood serves as CCLP's Deputy Director of Strategic Priorities. She is an expert in public health insurance plans (Medicaid and CHP+), Aid to the Needy Disabled, immigrant access to services and health equity. Staff page ›

Mar 22, 2018

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Medicaid work requirements advance a harmful narrative

by | Mar 22, 2018

Our state’s Medicaid program, Health First Colorado, is an investment in the health of our communities. The program exists to ensure that poverty is not a barrier to the health care services that Coloradans need to concentrate in school, excel in the workplace, and take care of themselves and their families.

Introduced earlier this week, Senate Bill 214 would undermine Health First Colorado’s mission by requiring program administrators to divert significant time and resources to tracking the job status of enrollees, and cutting our neighbors off the program if they are unable to comply with the reporting requirements or find a job. The price tag of SB 214 alone should compel us to reject this harsh, potentially harmful and costly legislation. Implementing similar requirements in Kentucky is expected to cost close to $374 million over the next two years.

But the even bigger problem here is the assertion that this type of legislation makes about Coloradans living in poverty. The monitoring SB 214 envisions is based on the flawed assumption that poor people will not work unless they are forced to work. But findings from Colorado Department of Health Policy and Financing (HCPF) indicate that 75 percent of Medicaid adults already have a job. In reality, those who live below the poverty line in our state work hard to support themselves and their families — often working multiple jobs while earning wages that are insufficient to put food on the table, cover rent and utilities, and pay for doctor’s visits without public support.

Non-working Coloradans living below the poverty line find themselves in challenging circumstances because they are living with a mental or physical disability, struggle with addiction, have a criminal record or face other substantial barriers to employment that work requirements do not address. The loss of health care coverage will only exacerbate these setbacks.

Moreover, poverty is many times more likely to create barriers for those that experience racism and other forms of oppression in our society. The inability to get by in Colorado is not only the result of insufficient resources but is also the result of systemic oppression of people of color, people with non-conforming gender identities, people that live in poorly resourced neighborhoods, and people that live in the rural regions of our state. Undermining a critical safety-net program like Health First Colorado will hurt these populations most, and by causing that harm, will undermine the strength of our entire state.

While voluntary work support programs have been successful in helping benefit recipients secure and maintain employment, conditioning public support on employment has not worked in other states in the past, nor will it work in Colorado in the future. In a study done in Ohio, 52 percent of employed Medicaid recipients reported that Medicaid coverage made it easier for them to continue working. If the goal is to get people back to work, the state should give Coloradans the skills they need to get a job, not penalize them for their inability to work, as Laurie Harvey, the retiring President and CEO of the Colorado Center for Work Education and Employment (CWEE) explained in this recent commentary.

CCLP joins its partners, including health care providers, patient groups, and advocates for people with disabilities in strongly opposing SB 214. Scheduled to be heard by the Senate Health & Human Services Committee on Thursday, March 29, the bill is a thinly veiled attack on the Medicaid program that comes just months after Congress repeatedly rejected the Trump administration’s efforts to cap and deeply cut Medicaid. We call on all Coloradans to voice their opposition.

– By Allison Neswood

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