Pa. Human Services head cites expense of forcing Medicaid recipients to get jobs

Among the hot-button issues for members of the Pennsylvania House of Representative's Appropriations Committee at Tuesday's hearing for the state's Department of Human Services was their desire to require able-bodied Medicaid recipients to work — for the sake of constituents who go without services "because someone else is getting a free ride."

"We're not doing enough here to get people into jobs," State Rep. Stan Saylor (R., York), chairman of the committee, told acting Secretary Teresa Miller, who spent about five hours testifying during morning and afternoon sessions. Saylor spoke of seniors who can't get needed services because of the "free ride" others are enjoying.

Brad Roae (R., Crawford) cited research showing that the work requirement might affect only 7 percent of the state's Medicaid beneficiaries and mentioned a half-dozen states that have applied with the federal government for waivers that would allow the institution of a work requirement for Medicaid benefits.

Miller countered that under proposed legislation the state would have to spend an estimated $600 million and add 300 staff to implement the systems and supports required by the federal government to help people get and keep jobs if the state had a work requirement for Medicaid.

"We would have to build quite a bureaucracy to support that," she said, adding that the federal government would not share in the cost of those supports.

Roae said he was surprised that Gov. Wolf did not mention that in his letter to the General Assembly last year when he vetoed a bill that would have instituted a work requirement.

The department's budget this year is $12.56 billion, making it a fat target for legislators. Nearly three quarters of that money goes for health care, long-term living, and intellectual-disability services. Cash assistance accounts for $6 million, or about 0.05 percent of the total.