Wisconsin Republican Gov. Scott Walker, who has refused millions of dollars in federal funding for Medicaid expansion under the Affordable Care Act (ACA), wants his state to become the first in the nation to make Medicaid applicants undergo a drug test in order to qualify for benefits under the safety-net program.
Walker, who is one of several Republican governors pushing for conservative changes to Medicaid in the wake of last month's TrumpCare debacle, will present the proposal to the public on April 19, take comment for one month, and then send a formal request to the Trump administration.
According to the Milwaukee Journal-Sentinel, which interviewed Walker last week, he "and aides think the governor's proposal is likely to be approved by the Trump administration because it loosely mirrors some actions taken in Indiana under that state's former governor, Vice President Mike Pence, and Seema Verma, a former consultant to Indiana who is now head of the federal Centers for Medicare and Medicaid Services."
Pence and Verma, along with Health and Human Services Secretary Tom Price, are seen as leaders in the Republican effort to gut Medicaid or make it crueler, whether through block-grant or per-capita-cap schemes (like the one found in the GOP's American Healthcare Act, or AHCA) or via other avenues like imposing work requirements (a provision that also showed up in the AHCA).
The Washington Post reported Sunday that Walker's "approach—which also would mandate treatment for those testing positive—aligns with the goals of several Republican governors intent on tightening the program's rules. Although the Obama administration allowed them to place expectations on enrollees, they're hoping for far more leeway from" the Department of Health and Human Services under Price.
The Post noted that governors in Indiana, Arizona, Kentucky, Pennsylvania, and Arkansas have all either requested or plan to request a work requirement for Medicaid beneficiaries.
"Red states have good reason to believe they'll be successful," the Post wrote, citing a letter sent in March from Price and Verma to governors, indicating "that proposals related to 'training, employment, and independence' would be welcome."
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Indeed, the Kaiser Family Foundation concurred in a brief last month that while the Obama administration "concluded that work requirements were not related to Medicaid's objectives of increasing access to coverage and care...the new administration has signaled that it may reach the opposite conclusion."
This would not be a positive development, argued MaryBeth Musumeci, KFF's associate director for the Program on Medicaid and the Uninsured. "[C]onditioning eligibility for health coverage on satisfying a work requirement," she wrote, "and terminating health coverage for those who are unable to comply, could penalize the people who most need these supports."
Meanwhile, Walker's drug-testing proposal is likely to meet stiff resistance in Wisconsin, where Robert Kraig, executive director of Citizen Action of Wisconsin, told the Post: "We're singling out lower-income people, playing on stereotypes, on the premise that somehow people on Medicaid are getting something they shouldn't be getting."
Scott Walker is no stranger to bad ideas, but drug testing for Medicaid is one of his worst & cruelest:https://t.co/4XaFwvJH6p
— flippable (@flippable_org) April 3, 2017
— Families USA (@FamiliesUSA) April 3, 2017
"Does Scott Walker really hate poor people that much, or does he just find it convenient to scapegoat them as a means to getting himself more power?" wondered Daily Kos columnist Laura Clawson. "Maybe it doesn't matter—he's evil either way."