In a direct reversal of the the previous LePage administration's request, Janet Mills has rejected new federal work requirements for Medicaid recipients.

On January 22, the Mills administration announced they had sent a letter to the U.S. Centers for Medicare & Medicaid Services informing them that Maine wouldn’t accept the terms of the pending 1115 Medicaid waiver, which encourages states to mandate that non-disabled, non-elderly Medicaid recipients must work at least 80 hours a month or risk losing their health insurance.

“Maine’s low unemployment rate, its widely dispersed population, and our lowest per capita income in New England make mandates — without appropriate supports like vocational training and specific exemptions for groups like people undergoing treatment – problematic,” wrote Governor Mills in a press release. “We believe that the likely result of this 1115 demonstration would leave more Maine people uninsured without improving their participation in the workforce.”

Instead of work requirements, the Mills administration plans on expanding job training programs while increasing access to needed services that keep people in the workforce. Some of the ways the administration plans on doing this includes maximizing the use of TANF funding (which helped 5,700 Mainers find jobs through job search and readiness training), rapidly implementing the Higher Opportunity for Pathways to Employment (HOPE) program, and connecting food stamp recipients with official job boards through the Maine Department of Labor. 

According to Acting Commissioner of Health and Human Services Jeanne Lambrew, waiving protections against high premiums and for retroactive coverage would only reduce access to critical coverage, which in turn exacerbates the workforce shortage in the state.

“Ensuring that Maine people have access to health care and are healthy is the first step to getting them back into the workforce,” said Acting Commissioner Lambrew. “The Maine Department of Health and Human Services will continue to see that Maine people have healthcare coverage that enables them to find work.”

Progressive politicians and advocacy groups in Maine lauded Mills’ decision to reject work requirements, saying that they accomplish exactly the opposite of what Medicaid is supposed to be all about — namely serving the health and wellness needs of low-income people — because those without access to health care tend to get sicker and have a hard time holding down a job. 

“The reality is that our economic system and our health care system do not work for people with low incomes without programs like Medicaid,” said Kathy Kilrain Del Rio, a policy analyst at Maine Equal Justice Partners. “Low-wage jobs without health benefits, the gig economy, discrimination, and our broken immigration system make it difficult if not impossible for many people to gain financial security and get the medical care they need and deserve.”

In Arkansas, which approved the 1115 waiver last March, 18,164 individuals lost their coverage due to failing to meet their new work requirements, according to a report by the Henry J. Kaiser Family Foundation.

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