The Ohio House is looking over a new budget proposal that has a fair share of controversial recommendations. One that’s catching the eye of many advocates is a new requirement for the 700,000 people getting Medicaid through the expansion pushed by Gov. John Kasich in 2013.

The House version of the state budget says those who want to qualify for Medicaid under the expanded coverage would have to be 55 or older, have “intensive health care needs,” be in school, be participating in an alcohol or drug addiction treatment program, or have a job.

Steve Wagner with the Universal Health Care Action Network is adamantly opposed to these provisions and says the job requirement is especially counterintuitive.

“If they have an illness, if something happens that makes it that much more likely that they’re not going to find work.”

He adds that the language about intensive health care needs is ambiguous. On the other side is Greg Lawson with the conservative think tank the Buckeye Institute. He’s all for the Medicaid expansion requirements but he thinks that ambiguous language can create loopholes.

“A situation that you can drive a whole truck through potentially. I think that’s a problem so we’d like to see things tightened up on that.”

An additional change

These requirements come on top of a proposal for expanded Medicaid enrollees to pay a premium, under $20 a month, in order to partake in the program. Supporters say a premium will get enrollees used to paying for their health care coverage for when they’re no longer on Medicaid. But opponents believe the premiums add just another financial hurdle for people already struggling with their finances.

None of these changes can take effect unless the federal government approves a waiver, which supporters think is more likely to happen now under a Trump administration than in the past.