Cameron says that if elected governor he would resume efforts, thwarted by federal court, to add work requirement to Medicaid

Attorney General Daniel Cameron

Attorney General Daniel Cameron said Wednesday that if elected governor he would quickly restart Republican efforts to "require some able-bodied adults to work in exchange for health-care coverage through Medicaid," Bruce Schreiner writes for The Associated Press.

When Republican Matt Bevin was governor, he tried to require able-bodied Medicaid recipients who were not caregivers to work, enroll at least part-time in education or job training, volunteer, or perform other “community engagement” activities to qualify for benefits. A federal judge in Washington, D.C., blocked the move, saying it was not allowed under the 1965 law that created Medicaid and Medicare and noting state estimates that almost 100,000 people would lose coverage, mostly 

After Democrat Andy Beshear defeated Bevin in 2019, he dropped the state's appeal of the court decision, saying his action was the “moral, faith-driven thing to do.” Beshear calls health care a “basic human right,” Schreiner notes. Cameron said Medicaid work rules would be “one of the first things I will do as governor.”

Cameron raised the issue in the primary election, and Wednesday in answering a question about Kentucky's low workforce participation rate at a Kentucky Farm Bureau Federation forum that Beshear did not attend.

“If we want the plan and the coverage to exist and remain solvent for those that are means-tested and medically necessary, we need to make the program, as best as possible, transitory – something that folks will come off of if they are able-bodied individuals,” he said.

In a statement issued later by his campaign, he said, “We will protect the truly vulnerable but we will not allow able-bodied people to take advantage of taxpayer generosity.” The campaign said the plan would exclude able-bodied adults who are “truly vulnerable,” including those with children or who are pregnant.

Work rules require waivers from the federal government. Bevin got one from the administration of Donald Trump, but Joe Biden's Department of Health and Human Services has generally resisted the idea.

Schreiner notes, "Medicaid is a joint federal and state health-care program for poor and disabled people. Advocates have said work requirements would become one more hoop for low-income people to jump through, and many could be denied coverage because of technicalities and challenging new paperwork."

Kentucky's Medicaid rolls grew by hundreds of thousands in 2014 when then-Gov. Steve Beshear, the current governor’s father, expanded the program to cover able-bodied adults under the 2010 Patient Protection and Affordable Care Act, generally known as Obamacare. "For many Kentuckians," Schreiner notes, "it was their first time to have health coverage in a state plagued by high disease rates."