January 23, 2019

Mills rejects LePage's work requirements for Medicaid recipients, outlines new policy

Courtesy / Office of Gov. Janet Mills
Courtesy / Office of Gov. Janet Mills
Gov. Janet Millls has directed acting Commissioner of Labor Laura Fortman, left, and acting Commissioner of Health and Human Services Jeanne Lambrew, to make vocational training and workforce supports available to MaineCare participants at every opportunity.

Gov. Janet Mills told the federal Centers for Medicare & Medicaid Services on Tuesday she is rejecting work requirements for Medicaid recipients sought by former Gov. Paul LePage and approved by the Trump administration last month.

In her Jan. 22 letter to CMS Administrator Seema Verma, Mills informed the agency that Maine will not accept the terms of the pending 1115 Medicaid waiver requested by LePage. Instead, Mills told Verma, she has directed acting Commissioner of Labor Laura Fortman and acting Commissioner of Health and Human Services Jeanne Lambrew to make available vocational training and workforce supports to MaineCare (Medicaid) participants at every opportunity while increasing access to needed services that keep people in the workforce.

"While we appreciate the Centers for Medicare & Medicaid Services' consideration, Maine's low unemployment rate, its widely dispersed population, and our lowest-per-capita income in New England make mandates — without appropriate supports like vocational training and specific exemptions for groups like people undergoing treatment — problematic," Mills wrote. "We believe that the likely result of this 1115 demonstration would leave more Maine people uninsured without improving their participation in the workforce."

Mills' letter continued: "Maine prefers instead to make employment and volunteer opportunities and training available to its low-income adult population to fully encourage work while providing access to the health care that is so vital to keeping people in the workforce. Additionally, Maine prefers not to increase administrative burden for medical providers and for the state that would result from a constant screening of patients' hours, categories, and types of community engagement. Instead, we should focus our resources on making the population healthy and work-ready to the fullest extent."

Mills said in a news release that her administration prefers to make training available to those enrolled in MaineCare, adding that she has directed Lambrew and Fortman to increase coordination between their departments to promote work-related opportunities.

Next steps to be taken

Many MaineCare recipients already participate in work programs and, through collaboration, DHHS and the Department of Labor will offer health and work opportunities to a greater number of people in the coming months, according to Mills.

Steps that will be taken by the Maine Department of Health and Human Services under Mills' direction:

  • Maximize the use of Temporary Assistance for Needy Families funding. The services provided through TANF include job readiness and job search trainings that prepare participants to enter the workforce; targeted skills development, training and education; connecting participants with employers, and job retention services once the participant has earned a job. In the last two years, the program has helped more than 5,700 individuals across the state get jobs.
  • Rapidly implement the Higher Opportunity for Pathways to Employment program, enacted during the most recent legislative session. As early as the next school year, the program will provide support for low-income families seeking higher education and skills training.
  • Connect participants in Maine's Food Supplement Program to jobs. For example, all food supplement recipients who meet the federal Supplemental Nutrition Assistance Program qualifications to be a work registrant (about 20,000 individuals) will set up a job link account with the Maine Department of Labor, which is designed to connect job seekers with employers. Additionally, Maine's Food Supplement Employment and Training Program has received national attention for its support of the two-generational post-secondary education program Family Futures Downeast. FSET also partners with Goodwill of Northern New England to develop job skills for SNAP recipients who voluntarily participate in the program.
  • Continue the SNAP to Skills Project. The program helps SNAP participants find work and reduce the need for food supplement support. Maine has committed to growing its FSET program and has a goal of bringing on new partners and serving SNAP recipients throughout the state.

The Maine Department of Labor will continue to target SNAP and TANF recipients through the Competitive Skills Scholarship Program, the CareerCenter system and the Workforce Innovative and Opportunities Act. Doing so, according to the release, will help them get work by:

  • Learning new skills to succeed in the changing economy through the Department of Labor's Competitive Skills Scholarship Program, which pays for education/training and support services for high-wage, in-demand jobs. Eligibility criteria include a family income of no more than 200% of federal poverty or family receipt of TANF or Food Supplement benefits and a desire to earn a marketable college degree or post-secondary occupational certificate that would lead to a high-wage and in-demand occupation.
  • Connecting TANF and Food Supplement participants to the Workforce Innovation and Opportunity Act education, employment and training services to promote education, training, and job placement.
  • Connecting participants with the Maine CareerCenter system, which provides assistance to job seekers. The centers offer training referrals, career counseling, job listings and similar employment-related services.

The health care-workforce connection

Acting DHHS Commissioner Lambrew said an important connection between health care and employment is at the heart of Mills' rejection of her predecessor's Medicaid work requirement policy.

"Ensuring that Maine people have access to health care and are healthy is the first step to getting them back into the workforce," she said in a news release. "Waiving protections against high premiums and for retroactive coverage would only reduce access to that critical coverage, including preventive services, mental health care, and treatment for substance use disorders. The Maine Department of Health and Human Services will continue to see that Maine people have health care coverage that enables them to find work."

Lambrew said she looks forward to working with Fortman, the acting labor commissioner, to connect MaineCare recipients with educational and training opportunities.

Fortman said she'll work with Lambrew to ensure that "educational and training opportunities are readily available to those on MaineCare."

"Maine is in the midst of a serious workforce shortage, which is why it is crucial that we continue to make sure that every Maine person has the support and resources they need to find and keep work," she said.


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