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Human Services Secretary Testifies Against Medicaid Work Requirements

by PA Department of Human Services

Jun 18, 2019

DHS Secretary Teresa Miller Outlines Wolf Administration’s Work to Support Paths to Employment for People Receiving Public Assistance

Harrisburg, PA – Department of Human Services (DHS) Secretary Teresa Miller last week testified at a joint State Senate Republican Policy Committee and Health and Human Services Committee hearing on the Medicaid work requirements. Secretary Miller spoke to the Wolf Administration’s firm opposition to work requirements for Medicaid recipients and the administration’s work to expand access to education and training programs and services to support employment for people served by DHS’ programs.

“Our goal is always to set policy and implement programs that empower Pennsylvanians to live fulfilling lives, support themselves and their families, contribute to our local economies, and build stronger communities,” said Secretary Miller. “This is not about opposition to work. We want all people to achieve a better quality of life and not be caught in an intergenerational cycle of poverty. The Wolf Administration is not simply opposed to a work requirement; we are committed to increasing opportunities for meaningful work and providing the whole-person supports we contend are needed.”

Governor Tom Wolf has made expanding access to health care a priority since first taking office. In February 2015, Gov. Wolf expanded Medicaid to more than 700,000 Pennsylvanians – many of whom were previously uninsured. Since then, more than 1.4 million Pennsylvanians have been covered at some point due to Medicaid expansion. This has helped Pennsylvania’s uninsured rate drop from 9.8 percent in 2012 to 5.5 percent in 2017 – the state’s lowest on record.

The Wolf Administration is also committed to strengthening Pennsylvania’s workforce through the Statewide Workforce, Education, and Accountability Program (SWEAP) and increasing opportunities for employment for people served by DHS’ programs. DHS is working closely with Medicaid’s managed care organizations (MCOs) to encourage a deeper focus on integrating employment and training initiatives into their managed care services as they are doing with other social determinants of health like housing and food access. Many MCOs have basic employment-focused services for Medicaid recipients, but there are opportunities to broaden these services and leverage partnerships with other social service organizations that help connect people to employment.

The department is also working with health care providers, MCOs, social services organizations, and other stakeholders on an assessment to determine how individuals are affected by social determinants of health like employment and education or training level. The goal is to establish a uniform way to evaluate risks and opportunities to better serve patients and clients through referrals and connections to agencies who can provide services needed.

DHS is also partnering with the Department of Labor & Industry (L&I) to redesign employment and training programs for Pennsylvanians receiving Temporary Assistance for Needy Families (TANF), many of whom are also covered by Medicaid. TANF and the Supplemental Nutrition Assistance Program (SNAP) have existing work requirements, but some programs established to meet these requirements have not seen positive lasting outcomes. The redesign will shift the Employment Access and Retention Network’s (EARN) focus from job placement, which does not always address barriers to finding and keeping a job, to long-term success through comprehensive case management that will address barriers like education level, transportation, and child care and prioritize long-term goals. This approach will help address inter-generational barriers that trap people in a cycle of poverty.

The 2019-20 budget includes a proposed $5 million to support start-up and implementation costs for up to seven Parent Pathways programs, a post-secondary education and training program targeted towards single-parent families. Modeled off Misericordia University’s Women with Children Program, these models will help break barriers to post-secondary education for single-parent families and provide housing, child care, and other supportive services to help change long-term economic trajectories for single-parent families.

Secretary Miller also shared experiences of states who have received approval from the federal government for a Medicaid work requirement and have implemented the requirement. Nine states have been approved, but only two – Indiana and New Hampshire – are currently operating. Both Arkansas and Kentucky had their work requirement halted by a federal judge because the disregard for coverage losses violate the core objective of the Medicaid program: to help people in need access health care. Kentucky’s program was halted before it could be implemented, and Arkansas’ was halted in March 2019, less than a year into implementation. In the first months, more than 18,000 people lost Medicaid coverage.

“We must learn from our and other states’ experiences and not repeat or worsen past mistakes. We have seen the impact of a work requirement – it traps people in a cycle of poverty,” said Secretary Miller. “Let’s invest in the people served by DHS’ programs and support them in obtaining a living wage job, so they can transition off public assistance for the long-term.”

To learn more about DHS’ employment and training programs, visit

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