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Mississippi Medicaid Workforce Training Initiative - Updated

DateResponseResponse
Jul 20th 2018 7:35 am Response: #319221 Finding #1: Increases in employment among recipients subject to work requirements were modest and faded over time.

Evaluations of programs that imposed work requirements on welfare recipients found modest, statistically significant increases in employment early on among recipients subject to the requirements, but those increases faded over time. Within five years, employment among recipients not subject to work requirements was the same as or higher than employment among recipients subject to work requirements in nearly all of the programs evaluated.

In the first two years, the share of recipients subject to work requirements who worked at any point over that period was significantly higher — in nine of the 13 programs included in the analysis — than the share of recipients not subject to the requirements who worked, with the increase in employment ranging from 4.1 to 15.1 percentage points.[5] (See Table 1.) The biggest impacts on employment were found in programs in Riverside, California and Portland, Oregon.

Over time, however, work steadily increased among recipients not subject to work requirements, substantially closing the employment gap between the two groups. By the fifth year (the last year any of the studies examined), the impacts of the early years had eroded in each of the programs for which longer-term data are available. In five of the eight programs that initially produced a significant increase in employment rates, by the fifth year the program recipients not subject to the work requirements were just as likely — or more likely— to work than the program recipients subject to work requirements. The net impact fell most in the Riverside LFA (labor force attachment) program,[6] from an increase of 15.1 percentage points in employment rates in the first two years to a gain of just 4.2 percentage points in the fifth year. Similarly, in Portland, the net impact on the employment rate declined from an 11.2 percentage-point increase in the first two years to a barely significant 3.8 percentage-point increase in the fifth year.[7]

The impacts of work requirements were modest in most programs even in the early years, in part because work was far more common among recipients than is generally perceived. Over the five-year period, the vast majority of recipients worked, even if they were not subject to work requirements. In Portland, which excluded recipients with substantial employment barriers
Jul 20th 2018 9:46 am Response: #319249 Insufficient evidence that workforce training requirement would sufficiently tie to improved employment outcomes. Recommend striking "requirement".
-Sarah Herhold
Jul 25th 2018 4:35 pm Response: #319889 This is bad for Mississippi. We did not expand Medicaid. People who do get jobs will not qualify for Medicaid and overall health in our state will decline. This is immoral!
Jul 26th 2018 10:00 am Response: #319917 Mississippi Human Services Coalition grew out of grassroots civil rights activity in Mississippi as people sought to impact the implementation of federal policies that affect their lives. We have focused on Medicaid since its first implementation in MS in 1970.
Comments on Mississippi Revised Waiver Request which we oppose. The income eligibility for caretaker relatives in MS is very low. (Parent and 2 children = $384 while poverty level is $1701) 20 hours per week at Minimum Wage is $621.50 per month.

The request to require caretakers to work 20 hours per week would make most of them over the income limits. The state waiver request says that it cures this problem by extending Transitional Medicaid for another year. This does NOT solve the problem. Those individual who get work for 20 hours per week during the first three months of their eligibility will notbe eligile for TMA. TMA eligibility is now established ex-parte for those who have been on Medicaid for at least 3 months and whose income then exceeds the eligibility limit but is lower than 100% poverty level.
Current Medicaid policy requires no reporting during the transitional period except for changes in income. This waiver request would require 104 weekly documentations of meeting the work requirement. Mississippi Medicaid has not determined the nature or extent of such documentation. We assume that this new work requirement will result in those persons in TMA having to demonstrate that they actually worked their 20 hours each week, or they would lose their Medicaid at the start of the following month. Since they would then be over-income for regular Medicaid as a caregiver, they would have no way to regain their eligibility status.

The kind of work that these low-income parents can find to comply with the 20 hour requirement is limited in most communities .Many will work in restaurants. It should be noted that often restaurant work is irregular, with hours changing frequently. Some will find that they work 20 hours this week and 18 hours the following week. This could result in their being sanctioned for the shortened week through no fault of their own.
Earlier this year the city of Jackson, MS, had a water crisis that resulted in most restaurants closing for several days. Had we had the work requirements in place at that time, many recipients would have lost their eligibility. Other reasons that people who regularly work 20 hours per week may fail to meet that goal
Aug 10th 2018 3:12 pm Response: #325341 I am grateful for the opportunity to comment on the Mississippi Division of Medicaid’s Medicaid Workforce Training Initiative 1115 Demonstration Waiver Application, which proposes to take away health coverage from individuals who don’t meet rigid work requirements. I am most concerned about how Mississippi's Medicaid 1115b waiver request will negatively impact children. The proposed Medicaid Workforce Training Initiatives unfairly targets low-income mothers and children who are among the primary beneficiaries of Medicaid in our state. Under the initiative, mothers will have to choose between caring for their children and losing their health coverage or paying for expensive childcare in order to work and maintain their coverage. This must not go forward. Medicaid is Health Insurance not Unemployment Insurance. Our citizens have some of the worst health indicators and the caregivers will have added stress trying to coordinate care for those who are ill and the children while they go to work for minimum wage.

Kathy Sykes
ksykes@house.ms.gov
Aug 14th 2018 9:10 am Response: #345917 Many people on Medicaid already are working, sometimes 2 jobs to make an income. The majority of Medicaid patients are disabled and cannot do the work requirements. When the government assumes that a person on Medicaid is lazy, that is inaccurate. Now if the patient on Medicaid worked too much, they would lose their health coverage. Sorry, I just don't see how putting work requirements on everybody on Medicaid is going to help.
Aug 14th 2018 9:30 am Response: #345933 Through work I've done in the Mississippi Delta, I've had the opportunity to meet poor families who face true barriers to accessing childcare, jobs, and transportation. Many people do not and cannot afford a car and thus are unable to get to jobs that are located a 30-45 minute drive from their homes in rural Mississippi.

Parents who have access to health care are better able to nurture and support their child’s healthy development. Studies show that when parents are uninsured, children tend to go to the doctor less frequently and are less likely to have their own coverage. Additionally, as parents become uninsured, the entire family is at greater risk for medical debt and even bankruptcy – moving these families in the opposite direction of economic self-sufficiency.

Mississippi is known as the hospitality state. I believe it is important that the state leaders follow the values of charity that Mississippi is known for and protect vulnerable children and families.

-signed by a former Mississippi resident, University of Mississippi graduate, and a healthy policy analyst
Aug 14th 2018 9:33 am Response: #345941 Without adequate health care our nation will fast become a nation of such people and require more expenditures than we already have.
Aug 14th 2018 10:02 am Response: #345949 I believe a work initiative is a valid requirement ONLY if you are paying the participants a decent living wage. Since minimum wage is at 7.25, the proposal is not feasible and will cause more harm than good to poverty stricken families. See living wage link below.


http://livingwage.mit.edu/states/28
Aug 14th 2018 1:48 pm Response: #346509 I am grateful for the opportunity to comment on the Mississippi Division of Medicaid’s Medicaid Workforce Training Initiative 1115 Demonstration Waiver Application, which proposes to take away health coverage from individuals who don’t meet rigid work requirements.

The proposed Medicaid Workforce Training Initiatives unfairly targets low-income mothers and children who are among the primary beneficiaries of Medicaid in our state. Under the initiative, mothers will have to choose between caring for their children and losing their health coverage, or paying for expensive childcare in order to work and maintain their coverage.

Many single mothers in our state who rely on Medicaid live on less than $500 a month. One medical emergency could lead to food insecurity or homelessness, which is a catastrophic consequence for a family struggling to make ends meet. Even seemingly routine visits to the doctor for minor illnesses could result in overwhelming debt for mothers, effectively decreasing their ability to move out of poverty.

Medicaid currently works for so many of Mississippi’s mothers and children, but the proposal to take health coverage away from parents who can’t meet work requirements would be detrimental to these families by placing an unreasonably heavy burden on parents who are simply seeking to access proper health care for their children.

I have a “Little Sister” who has a baby. She is 15. This is going to affect the most vulnerable element of our society. Please don’t do this.

A. Owen
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