Analysis Finds Oklahoma's Proposed Medicaid Work Requirements Would Mostly Affect Poorest Mothers
More than three-fourths of the nearly 6,200 people that would be subject to Oklahoma’s proposed Medicaid work requirements are mothers.
The state is asking the federal government to approve a waiver requiring people to work, volunteer or participate in job training 20 hours a week unless they qualify for an exemption.
An analysis of Oklahoma's proposal by the Georgetown University Center for Children and Families and Oklahoma Policy Institute found 78 percent of the 6,193 adults the work requirements would apply to are mothers. They’re most likely to be white and are more likely to live in rural areas and small towns.
And they will be in deep poverty, most earning less than $400 a month for a family of three.
"Now, most importantly, the vast majority — 85 percent — of these parents have been in the workforce or have a family member that has been in the workforce over the past six months," said CCF Executive Director Joan Alker.
Because Oklahoma didn't expand Medicaid under the Affordable Care Act, only adults living at or below 45 percent of the federal poverty level are eligible. That's under $800 a month for a family of three.
Variety Care Chief Medical Officer Dr. Nathan Valentine said that puts a mom trying to hold down a minimum-wage job in a predicament.
"She’s stuck in a position where if she says OK to that extra shift, even if she only works 86 hours that month, then she’s going to be considered too wealthy and would lose her health care coverage," Valentine said.
While Oklahoma would tie Medicaid eligibility to work, unlike other states with Medicaid waivers, Oklahoma is not doing anything to help those affected find work.
"This is not a proposal that can be fixed. It really should be dropped," Alker said.
The review also said the process for those seeking an exemption is unclear and Oklahoma’s reporting requirements will likely be too difficult to comply with, leading to people unnecessarily losing coverage.
Alker said there could also be an increase in the number of uninsured children because while kids qualify for coverage even when parents don’t, uninsured parents are more likely to have uninsured kids.
The Oklahoma Health Care Authority is currently accepting public comments on the proposal, requested by Gov. Mary Fallin and state lawmakers earlier this year. The agency expects to submit it by Oct. 1, which could put the work requirements in place next February.
Alabama, Mississippi, South Carolina and South Dakota are requesting similar waivers and have not expanded Medicaid, either. The only states to have waivers approved — Arkansas, Indiana, Kentucky and New Hampshire — did expand Medicaid. Kentucky's waiver, however, was blocked by a federal court.