Beth Harwell proposes TennCare work requirements

Tennessee House Speaker Beth Harwell filed a bill Thursday that aims to require able-bodied adults without young children to work if they want TennCare health coverage.

The proposal would accept an offer by President Donald Trump's administration Thursday for states to implement Medicaid work requirements, which Harwell said was the type of flexibility states have requested for several years.

But the effect of that change in Tennessee would be limited under TennCare's tight qualifications, House Minority Leader Craig Fitzhugh said. The main group that appears would be affected would be parents or caretakers with children from 6 to 20 years old.

To receive TennCare, you must be pregnant, a child under age 19, a parent or relative caretaker of a dependent child under age 21, disabled, elderly or uninsurable, and meet financial requirements.

The Trump administration's guidance exempts several major categories of TennCare: pregnant women, disabled people, children and the elderly. Additionally, the federal policy calls for taking into account people from areas of high unemployment or caregivers for young children or elderly family members. "Reasonable modifications" would be made for people with substance abuse disorders.

Harwell's bill calls for a federal waiver to impose "reasonable" work requirements for able-bodied, working age adults without dependent children younger than 6.

"This legislation is about lifting people out of poverty, while still providing the support needed for Tennesseans to be successful and prosperous," Harwell, a Nashville Republican, said in the release.

TennCare spokeswoman Sarah Tanksley said the program is still trying to estimate how many people the change would affect. Of TennCare's 1.5 million recipients, more than half are 18 or younger.

The legislation comes amid a crowded race for governor featuring Harwell, who is running against U.S. Rep. Diane Black, former state Sen. Mae Beavers and businessmen Randy Boyd and Bill Lee in the Republican primary. Fitzhugh is running as a Democrat against former Nashville Mayor Karl Dean.

Earlier Thursday, Black said she has pushed for the work requirements as Budget Committee chairwoman, and would look to implement the change if elected governor.

"It's not just about protecting taxpayer dollars from fraud and abuse," Black said in a statement. "It's about creating a culture of work and the dignity that comes from that work. Having grown up in a family that had to work hard for everything we had, I know that work is the only way up in this great country."

Fitzhugh said that, due to the limited effect of the change, he doesn't have a problem with it, though it may not make economic sense for the few it will impact.

"I can see where people that have children that they're caring for, now if they have a work requirement, will have to go to work and pay child care," Fitzhugh said.

State House Democrats have begun an election-year legislative session by continuing to call for majority party Republicans to pass Medicaid expansion under former President Barack Obama's health care law. Lawmakers killed an expansion proposal backed by Republican Gov. Bill Haslam in 2015, and the administration doesn't plan to revive it this year.

Fitzhugh said Thursday that if lawmakers would expand Medicaid, he would support the work requirements and some type of copays for the new and existing TennCare recipients.

Harwell spokeswoman Kara Owen said her proposal, however, is not about expanding Medicaid.

Georgetown Republican Rep. Dan Howell will carry the bill.