Florida House Committee Approves Bill to Impose Harsh Medicaid Rules on Low-Income Parents

A Florida House Committee recently (3/13) approved HB 955, on a party line vote, a bill that would authorize the Governor to seek a Section 1115 Medicaid waiver to impose likely the most punitive work reporting requirements in the nation on very poor parents receiving their health coverage through Medicaid.

Because Florida has not expanded Medicaid under the Affordable Care Act, the only adults who would be impacted are very poor parents whose income falls below 33 percent of the federal poverty level.

If this bill becomes law, it would be the harshest (and that is saying something!) that I have seen so far – with no parent excluded unless they have a newborn under 3 months old. Parents with children over 3 months and under age 6 would have to report 20 hours per week of work, job search, training or other allowable activities. Parents of children age 6 and older would have to report 30 hours per week of these activities.

There is no provision in the bill that would attempt to help parents find child care or provide additional resources to ensure they have child care – so this creates an extraordinary choice for parents – the majority of whom are likely mothers. These women could potentially lose their health care if they don’t start working more than 20 hours a week, and if they have an infant or young child, they face the real possibility of having to leave their young children in inadequate or potentially unsafe child care arrangements.

Parents subject to the new reporting rules will find themselves in a catch-22 situation. Working 20 hours per week at Florida’s minimum wage of $8.46 per hour would earn a parent about $677 per month, well above the 33% of federal poverty level limit for Medicaid eligibility in Florida for parents and caretakers. They would make too much money for Florida’s extremely low income eligibility level if they comply, but would be ineligible if they didn’t report sufficient hours. And of course for the parents reporting 30 hours per week, they’d be out of luck too. Medicaid for these low income parents would essentially be eliminated even though they are a mandatory coverage category under federal law.

While Florida’s plan is the harshest, it is not unique. Five states have waiver proposals pending with the federal government that seek to condition Medicaid eligibility on compliance with new and complex work reporting rules solely for parents and South Carolina has a proposal up for comment at the state level. Meanwhile, a federal judge is expected to rule this week on the legality of the Trump Administration’s approval of such requests in the cases of Kentucky and Arkansas.

I could say more but that is enough for now. Let’s hope that this bill proceeds no further.

Joan Alker is the Executive Director of the Center for Children and Families and a Research Professor at the Georgetown McCourt School of Public Policy.