WATCH: Kennedy urges Gov. Edwards to require work for Medicaid

US Senator John Kennedy (R-Louisiana) - Photo by Gray DC Bureau
US Senator John Kennedy (R-Louisiana) - Photo by Gray DC Bureau(Gray D.C. Bureau)
Published: Oct. 19, 2017 at 2:24 PM CDT
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Louisiana Senator John Kennedy (R-La.) is urging Governor John Bel Edwards to consider a plan that would require some Medicaid recipients in the state to have to work in exchange for benefits.

Edwards sent the Governor a letter Monday highlighting possible ways to save Louisianans money. Specifically, Kennedy pointed out the benefits of enacting work requirements for Medicaid recipients.

Here is what Kennedy told our Gray DC Bureau reporter Alana Austin Thursday:

“Medicaid is - well let me start this way. Health care is very, very important to the American people and it’s really important for the people in Louisiana. The American people and the people in Louisiana are the most generous people in the world. We spend a trillion dollars a year helping those left less fortunate than we are. If you’re too poor to be sick, we don’t let you die in America. We - we’ll pay for your health care... but we have to be mindful of the cost.

"In Louisiana, we’re spending half of our budget on Medicaid, half of our budget on Medicaid. And the Governor’s says ‘well it’s all federal money.’ Well first, federal money’s taxpayer money but that’s not accurate. In order to attract that federal money, we have to spend state money and we are spending well over three billion dollars this year in state money on Medicaid and it goes up every year and it’s crowding out funding for universities and public schools and roads and public safety.

"Now, the answer is to do what other states are doing, try to control the costs of Medicaid. Governor Edwards’ entire plan is send me more money, gimme more money, gimme more money, welp, Medicaid’s already getting 47 percent of our budget. Other states are doing some innovative things. I sent the Governor a letter this week - made seven suggestions of changes he could make on our Medicaid program, which wouldn’t hurt quality of care and would save taxpayers money. These are not my original ideas - I just copied what other states are doing.

"Let me tell you about one: I’ve asked the Governor to seek permission from President Trump - who will say yes by the way - to implement a work requirement for Medicaid, and here’s how it would work: if you’re between the ages of 18 and 55 and you don’t have any children and you’re not disabled, then if you’re poor, we will give you free medical care under Medicaid but in return you’ve got to agree to work 20 hours a week. We’ll get you a job or go to job training for 20 hours a week or do community service for 20 hours a week.

"Our goal here is not to throw anybody out in the cold. Our goal here is to try to help people who don’t have a job but could work if they wanted to get a job so they’re self-sufficient so they don’t need Medicaid, and for the life of me I don’t know why Governor Edwards won’t support that. Again I’m not talking about a mother with a sick child in her arms. I’m not talking about asking grandpa to leave the nursing home in his wheelchair and go to work. I’m just saying if you’re between 18 and 55, if you have no kids, and if you’re able bodied, you’re not disabled then you have to work 20 hours a week.

"President Clinton did this same exact thing with welfare in 1996 and it’s worked beautifully and it will work in Medicaid and I do not understand - for the life of me - why Governor Edwards will not support it. Other states are asking for permission to do it, Kentucky for example and I’m just asking the governor to copy them. I told him in my letter, I said look, here’s the idea of work requirements. I gave him six other suggestions. I said I will get you a meeting with the Trump administration. I’ll introduce you to the people in the other states whose programs we’ll copy. I’ll even get him a meeting with President Trump, but I just don’t know why he won’t support this. I just don’t know why he won’t support this.

"The goal of all of America’s social programs and, by the way, as I said, we’re spending a trillion dollars a year. The goal of all of these social programs where we try to help our less fortunate neighbors should be a job. And the problem is that many of these social programs, which were supposed to be bridges, have become parking lots, and what I’m suggesting will be good for the folks on Medicaid. It’ll be good for the Louisiana taxpayer. It’ll be good for the American taxpayer if we introduce people to the dignity of work and the dignity of being self-sufficient, they’re going to feel better about their lives.”

Below is the text of the letter Kennedy sent to Edwards:

The Honorable John Bel Edwards


State of Louisiana

P.O. Box 94004

Baton Rouge, Louisiana 70804

Re: Medicaid cost savings

By email, fax and U.S. mail

Dear Governor Edwards:

As you are aware, our Medicaid spending in Louisiana is growing at an alarming rate. In Fiscal Year 2008-09, we spent $6.6 billion on the Louisiana Medicaid Program. $1.5 billion of that was state taxpayer money and $5.1 billion was federal taxpayer money. The Louisiana Medicaid budget for this fiscal year, 2017-18, was appropriated at $12.5 billion. $3.3 billion of that is state taxpayer money and $9.1 billion is federal taxpayer money.

Thus, in 9 years, overall Medicaid spending is up 90%. The state Medicaid contribution is up 120%, an average of a whopping 13% a year. Federal monies are up 80%.

Louisiana now has 1.6 million Medicaid enrollees, about 440,000 of whom were added under Obamacare. 65% of all babies born in Louisiana had their births paid for by Medicaid.

Top quality health care for our people is extraordinarily important. (No reasonable person has ever described Medicaid as “top quality,” but we can discuss that another time). So, however, are other things, like elementary and secondary education, higher education, TOPS, roads and public safety. The massive, unchecked spending increases in Medicaid are crowding out spending on these other priorities. We need to do something about it.

The Trump administration is anxious to work with states on reducing Medicaid costs. In fact, you received a letter from the federal Department of Health and Human Services Secretary and the Centers for Medicare and Medicaid Services (CMS) Administrator in March of this year encouraging you to seek permission from them to experiment with new ways to more efficiently and effectively promote Medicaid’s objectives.

Other states are seizing this opportunity. Here is what some of them are doing:

1. Indiana is seeking CMS permission to require Medicaid recipients who are able-bodied, without minor children and not elderly to work at least 20 hours per week. According to a study by the University of New Hampshire’s Casey School of Public Policy, this is about 31.3% of the nation’s adult Medicaid enrollees. These enrollees would participate in Indiana’s Gateway to Work program. Gateway to Work helps participants fill out applications, build resumes, prepare for job interviews and search for employment. The objective, of course, is to get people into the workforce so they can purchase their own health insurance and know the dignity of being self-sufficient.

2. Indiana is also seeking permission to charge higher premiums to Medicaid enrollees who smoke cigarettes in the second year of enrollment.

3. Arkansas wants to add a work requirement to its program and help some Medicaid patients transition to private insurance through tax credits and other assistance.

4. Kentucky recently filed a CMS application to charge small monthly premiums for Medicaid participants. The premiums would range from $1 to $15. That little bit of money would add up to big savings of more than $300 million for the state of Kentucky. It also would reinforce the fact that everyone should have “skin in the game” and accept some responsibility for paying for a “free” government service that is not free at all, because taxpayers pay for it.

5. Kentucky and Arizona are seeking permission to require Medicaid enrollees to report changes in their income that would exceed the Medicaid limits.

6. Wisconsin is seeking CMS permission to drug test Medicaid applicants without children. Applicants who test positive will not lose eligibility for Medicaid but instead will be referred to a 90 day drug treatment program. A Medicaid applicant would not have to take an initial drug test if the applicant is willing to enter a substance abuse treatment program. The idea is to build a healthy population that is able to work.

7. Wisconsin is also seeking CMS permission to charge monthly premiums for Medicaid ranging from $1 to $10 per household according to household income, impose a small co-pay ($8 for the first visit) for Emergency Room visits, and ask Medicaid applicants to fill out a health risk assessment to identify unhealthy behavior that can be improved through patient education.

These are only some of the innovative steps other states are taking to save money in Medicaid, encourage work and improve health outcomes.

You should also know that these efforts are not only Trump Administration-encouraged initiatives. President Obama, for example, approved a waiver application by Arkansas to require its Medicaid beneficiaries to pay a small share of their health care.

I ask that you instruct your DHH Secretary to review these state proposals, develop a cost-savings plan for the Louisiana Medicaid Program, report the findings and seek legislative and CMS approval to implement them immediately. My office will be happy to assist you and DHH in developing such a plan and getting it approved.

Thank you, Governor, for your cooperation in this endeavor.


John Kennedy

U.S. Senate