Kentucky gov candidate backs some Medicaid work requirements

Create a work requirement for some able-bodied Kentucky adults receiving Medicaid health coverage

Republican gubernatorial candidate and current state Attorney General Daniel Cameron said Tuesday that he supports creating a work requirement for some able-bodied Kentucky adults receiving Medicaid health coverage, reigniting a contentious issue from the state's governor's race four years ago.

At a GOP candidates' forum in Paducah, Cameron pledged that if elected governor in November, he'd request federal permission to impose work rules for some Medicaid recipients. He's seeking to install a requirement that has run into resistance from the courts and President Joe Biden’s administration.

“On day one as your next governor, I will go to the federal government, I will ask for a waiver to make sure that we put a work requirement with those able-bodied recipients,” Cameron said. "Medicaid should not be a program that people stay on for the remainder of their life, especially if they can work. It needs to be transitory, so that we can save it for other folks that actually need it.”

Medicaid became a flash point during the state's 2019 gubernatorial campaign — won by Democrat Andy Beshear, who is seeking reelection to a second term this year.

After taking office, Beshear rescinded efforts by former Republican Gov. Matt Bevin to set work requirements for some able-bodied adults to receive Medicaid coverage. At the time, Beshear referred to his action as the “moral, faith-driven thing to do.” Beshear calls health care a “basic human right.”

Medicaid is a joint federal and state health care program for poor and disabled people. Advocates have said work requirements would become one more hoop for low-income people to jump through, and many could be denied coverage because of technicalities and challenging new paperwork.

The Trump-era plan by Bevin would have required that affected recipients either work, study, volunteer or perform other “community engagement” activities to qualify for Medicaid. A federal judge blocked the requirements before they took effect, but Bevin’s administration had appealed. Beshear said his action ended Kentucky’s involvement in the litigation.

Beshear said the plan would have stripped coverage for about 100,000 Kentuckians. Bevin’s administration estimated the work-related changes would have saved taxpayers more than $300 million over five years and said it would have encouraged people to be healthier.

On Tuesday, Cameron didn't provide details about what his proposed waiver would entail, but said that work requirements would improve the state's workforce participation.

Democrats pounced on Cameron’s remarks in trying to connect him to Bevin, who narrowly lost to Beshear four years ago.

Anna Breedlove, communications director for the Kentucky Democratic Party, said Cameron wanted to "reinstate the Matt Bevin policy to rip healthcare away from close to 100,000 Kentuckians.”

Cameron brought up the issue twice during the hourlong forum attended by three other GOP candidates for governor — state Agriculture Commissioner Ryan Quarles, state Auditor Mike Harmon and Somerset Mayor Alan Keck. Former United Nations ambassador Kelly Craft, who is also running, did not attend the event in western Kentucky.

Former Gov. Steve Beshear, the current governor's father, championed the state’s Medicaid expansion. Hundreds of thousands were added to the Medicaid rolls when Steve Beshear expanded the program to cover able-bodied adults. For many Kentuckians, it was their first time to have health coverage.

Twelve candidates in all are competing for the state’s Republican nomination for governor in the May 16 primary. The Kentucky campaign is drawing national attention to see if Andy Beshear, who has received consistently high voter approval ratings, can overcome his party’s struggles in the GOP-trending state.

Kentucky is among a number of states across the country where efforts to mandate work requirements for Medicaid recipients are underway, including South Dakota and Georgia.

In Arkansas, Republican Gov. Sarah Huckabee Sanders has said her state will ask the federal government to allow it to require people on its expanded Medicaid program to work.

Unlike the previous requirement, Sanders said, the latest proposal won’t cut off coverage to people who don’t comply. Instead, it will move them from the private insurance used for Arkansas’ expansion to the traditional fee-for-service Medicaid program.

A federal judge in 2019 blocked a work requirement for the Arkansas program advocated by Sanders’ predecessor, former Gov. Asa Hutchinson, who has launched a bid for president in 2024. Biden’s administration later rolled back work requirements in Arkansas and several other states. A federal judge last year cleared Georgia’s plan to partially expand Medicaid with a work requirement.