Medicaid work requirements don’t work. Maine was right to reject them.


The following op-ed was published in the Bangor Daily News by Mark James, a member of the Southern Maine Workers’ Center, with Meaghan LaSala, the board chair of the Workers’ Center

Medicaid work requirements don’t work. Mills was right to reject them.

On Tuesday, Gov. Janet Mills issued a letter to the Centers for Medicare and Medicaid Services rejecting Medicaid work requirements and other harmful barriers to health care sought by LePage-appointed Department of Health and Human Services administrators. As a member of the Southern Maine Workers’ Center, I spent the past year working to stop this waiver because I believe that health care is a human right. I’m pleased that Mills did the right thing and rejected these unjust and unnecessary barriers to health care.

Mills has unquestionably saved countless lives with this action. In Arkansas, the first state to implement Medicaid work requirements, more than 18,000 people lost health care coverage within the first four months of implementation.

I wasn’t working when I was diagnosed with non-Hodgkin’s lymphoma the first time. I was living in Aroostook County, in rural northern Maine, where there are not a lot of jobs. If I hadn’t had MaineCare, I probably would have died. Part of the reason I wasn’t working was because I was taking care of my best friend who was also sick with Parkinson’s disease. I didn’t know until he went to the hospital after we had been friends for years, that he was also dying of AIDS. He didn’t have other family to take care of him, and I stepped in. I have provided end of life care for several people including my partner of 27 years and my mother. While this has never been my paid labor, care work is real and hard work.

This fall, with other members of the Southern Maine Workers’ Center, I conducted interviews with low-income workers and people on MaineCare to understand what might get in the way of people meeting the proposed 20-hour a week work requirement. We heard many stories like mine.

Several people were unpaid caretakers for their children, parents or other loved ones. Some families decided that it made more sense to have someone not work and do informal caretaking, rather than pay someone else. One person described how hard it was for her to find child care while she worked the night shift.

Some said that while they desired to work full time, their employers only offered part-time positions. A rural worker struggled to maintain a job after their car broke down. A new immigrant reported having to drive two hours each way to find an employer in his field that would hire him because of discrimination. We spoke to a young worker who couldn’t find an employer willing to take a chance on him because of his juvenile criminal record.

Proponents say this policy is to incentivize work. I say these work requirements are set up to kick working poor people off MaineCare. Job requirements intentionally hide the fact that the majority of people on MaineCare already work, have disabilities, are caregivers or face other barriers to work that cannot be fixed with training programs. Only by guaranteeing all of our fundamental needs as human rights — including our human right to health care and to work with dignity — can we end poverty and racial injustice.

Rejecting the Section 1115 waivers was an important step to honor those human rights. Mills must follow through on the rejection of work requirements and the expansion of MaineCare by leading a robust effort to help Mainers who are eligible for MaineCare to enroll. The governor must also proactively address ways MaineCare continues to fall short of meeting people’s medical needs, including by restoring access to immigrants, and including comprehensive coverage of dental and reproductive care.

Maine needs a universal, publicly financed health care system that guarantees health care to all individuals, families and communities. Rejecting these work requirements was a necessary step to protect health coverage, and prevent us from moving in the wrong direction. We applaud Mills’ action as a huge step forward, and call for further action to ensure that MaineCare and Maine’s entire health care system meets the needs of all people.