Tennessee lawmakers could debate this session whether to add a work requirement to Medicaid, after President Donald Trump's administration said last month that it'd be willing to accept proposals that force enrollees to have a job, be training for one or engage in some sort of volunteer work.
The goal, according to the Trump administration, is to promote "better health" and financial independence through work. But Tennessee Gov. Bill Haslam says, there could be another, unexpected upside: It might bring Republicans skeptical toward Medicaid around to offering the coverage for more people.
Kentucky has already been given permission to require people to have a job or be in training to get on Medicaid. At least eight other states are proposing it.
A measure, House Bill 1551, filed last month in the Tennessee legislature would bring the idea here. It lets TennCare, as the state's Medicaid program is known, require work for "able-bodied" adults who don't have dependent children under 6.
It'd be a major change. But Governor Haslam says the idea has some merit.
"I think it actually will help people think long-term about, if we can make certain we have ways to control the cost, are we willing to expand who we cover?"
Three years ago, Haslam tried to expand TennCare to a quarter-million adults who can't afford coverage otherwise. Haslam got the Obama administration to make some concessions — like small co-payments — but that wasn't enough to get the GOP-controlled state legislature to go along. Haslam thinks a work requirement could shift the equation.
The requirement stands a good chance of passing. House Speaker Beth Harwell is championing the proposal. She's seeking to burnish her legislative record in her bid to succeed Haslam as governor.
Another gubernatorial candidate, House Democratic Leader Craig Fitzhugh, also supports the idea. He says the majority of people who'd benefit from expansion work already.
But that could be the proposal's undoing. Many argue there's no point in creating a costly bureaucracy to check work requirements if it's not going to save the state money by cutting Medicaid rolls.