Where do Nevada governor candidates stand on Medicaid work requirements?

Under Republican Gov. Matt Bevin, Kentucky is the first state planning to require Medicaid recipients to work or do community service activities in order to receive their health benefits, with some exceptions for people who are medically frail, pregnant or caregivers.

A governor, through his or her Department of Health and Human Services, is able to unilaterally apply for a waiver that would allow their state to impose such requirements on Medicaid recipients. They don’t need the Legislature’s approval to do so.

So where does Nevada’s governor stand on this new option afforded by the Trump administration? And what about those running for the office in 2018 who could spearhead a similar effort themselves?

Republican Gov. Brian Sandoval said his support of such a policy “depends.”

“It’s something I actually proposed in 2011 or ‘13, but it comes with not every single person is in a position to work who is a Medicaid recipient,” Sandoval said in an interview last week. “It would be something that would apply to able-bodied individuals who would have the ability to do that. That’s something I’ve explored before. We’ll see what comes out at the federal level.”

He said he suspects it’s something the Legislature could explore in the 2019 session, and noted that his proposal to bring work requirements didn’t get a hearing in the Legislature a few years back.

Republican Attorney General Adam Laxalt’s campaign didn’t return requests for comment, and his primary opponent, Republican Treasurer Dan Schwartz, also did not respond to requests for his position on the issue.

The Nevada Policy Research Institute has called on state lawmakers to adopt “common-sense reforms” such as Medicaid work requirements.

“Medicaid is supposed to provide a safety net for those who are unable to help themselves — an admirable goal,” said NPRI policy analyst Daniel Honchariw. “Unfortunately, as the system currently works, it actually encourages many able-bodied adults to stay out of the workforce. As a result, the program isn’t just draining public finances, it’s eroding the self-sufficiency of those it’s purportedly supposed to be trying to help.”

Democratic gubernatorial candidates say they are staunchly against the idea.

“Chris opposes this latest attempt by the Trump administration to target some of our most vulnerable populations,” said Eric Hyers, spokesman for Clark County Commissioner Chris Giunchigliani. “Most people who use Medicaid are already working, actively job-seeking, are unable to work or taking care of a sick family member. This could disproportionately affect senior citizens (who have worked for years), disabled populations and those struggling with addiction.”

Her primary opponent agreed.

"Medicaid supports the most vulnerable Americans - those who through illness, disability or age are most likely to be unable to work,” said Clark County Commissioner Steve Sisolak. “Nobody should ever be denied access to health care and as governor I will oppose any effort to create additional hurdles for the neediest among us."

Meanwhile, in Washington, Democratic Sen. Catherine Cortez Masto signed on to a letter to Acting Health and Human Services (HHS) Secretary Eric Hargan, questioning whether the Trump administration even had the authority to sign on to waivers that, the senators say, violate the intent of Medicaid legislation.

“Harmful ideological policies such as work requirements, mandatory drug testing, time limits, onerous cost-sharing and the like undercut and exceed the statutory authority provided to the secretary under Section 1115 and contravene longstanding congressional intent,” the letter said. “Ultimately, this leads to poorer health and more frequent use of the emergency room, all of which ends up costing the system and taxpayers more in the long run. Such harmful proposals clearly undermine the purpose of the Medicaid Act, prioritizing ideology over health.”

Disclosure: Steve Sisolak and Christina Giunchigliani have donated to The Nevada Independent. You can view a full list of donors here.