Montana HELP-Link: A Model for West Virginina to Move Medicaid Enrollees to Good Jobs

President Trump is promoting work requirements in the Medicaid program. In our blog on May 15th, we highlighted a couple of new resources that explain how a Medicaid work requirement could harm many West Virginians who rely on Medicaid. The Montana HELP-Link program provides an alternative to a mandatory work requirement that actually helps Medicaid enrollees receive the training and education that helps them move into jobs with decent wages that lift them out of poverty.  

President Trump is promoting work requirements in the Medicaid program. In our blog on May 15th, we highlighted a couple of new resources that explain how a Medicaid work requirement could harm many West Virginians who rely on Medicaid.

Under the federal guidance to states, a Medicaid work requirement cannot apply to pregnant women, primary caregivers of dependent children, individuals with disabilities, individuals with health-related barriers to employment, victims of domestic violence, full-time students, and “other populations with extenuating circumstances.” The guidance states clearly that individuals with opioid addiction and other substance use disorders should not lose access to appropriate Medicaid coverage and treatment services. That’s all good – but how do these categories of people know they are exempt and how do they apply for an exemption?

Failure to understand or to meet paperwork requirements – either to be exempt or to show hours of “work” - will knock Medicaid enrollees off the roles, and without care for conditions like diabetes, they will find it much harder to continue to stay healthy and work.

An Ohio analysis found that over half of expansion enrollees who are working (without being required to do so) reported that Medicaid made it easier for them to work – especially true for those in jobs that require physical labor. The Ohio analysis also found that enrollees who were unemployed but looking for work reported that having Medicaid made it easier for them to seek employment.

I believe that most policy makers across the political spectrum share this goal: All want to promote upward economic mobility and independence for West Virginia Medicaid enrollees.

Could a positive policy emerge to advance that shared goal? What would it look like? Will spending scarce state resources enforcing a work requirement – get any job you can or lose health care – promote true upward economic mobility? Evaluations of mandatory work programs such as in the Temporary Assistance for Needy Families (TANF) program found that a work requirement is not predictive of employment nor does it lift people out of poverty.

So what is needed to advance our shared goal?

First, we need to look at accurate data on Medicaid enrollees’ work participation and barriers to work. Nationally, according to the Kaiser Family Foundation, among nonelderly adults without a disability (on SSI) with Medicaid coverage—the group of enrollees most likely to be in the workforce—nearly 8 in 10 live in working families (with 64% with a full-time worker), and a majority are working themselves.

Second, we need to realistically assess jobs availability in our rural communities. Third, we need to take the time to have a discussion with public input from consumers and health providers that rely on Medicaid, as well as workforce development experts.

Fourth, we need to explore initiatives to give a real hand-up to West Virginians who want to work. Our state needs to be willing to invest funds to help people gain the skills needed to find a job that will lift them out of poverty.

A positive model for West Virginia is the Montana HELP-Link program. This program is an alternative to a mandatory work requirement that actually helps people on Medicaid enrollees receive the training and education that helps them move into jobs with decent wages that lift them out of poverty.

A new FACT SHEET from West Virginians Together for Medicaid describes how Montana HELP-Link reaches out to Medicaid enrollees and links them to job support services, skills training, and education.

With West Virginians lives on the line – we need to get this right.

Click here for a link to this report.

West Virginians Together for Medicaid