Tennessee House approves bill seeking federal OK for Medicaid work requirement

Debate on Gov. Bill Haslam's road and bridge funding bill takes place in the House of Representatives on Wednesday, April 19, 2017, in Nashville, Tenn. A Republican effort to remove Tennessee's first gas tax hike since 1989 from Gov. Bill Haslam's road and bridge funding bill was soundly defeated in the House on Wednesday. (AP Photo/Mark Humphrey)

NASHVILLE - The Tennessee House voted Monday night to direct the Haslam administration to seek a waiver of federal Medicaid rules to develop a plan imposing a work requirement on some able-bodied TennCare enrollees.

The bill, sponsored by House Speaker Beth Harwell, R-Nashville, and carried by Rep. Dan Howell, R-Georgetown, was approved along party lines 72-23 after a spirited debate and unsuccessful attempts by Democrats to amend it.

"It's a very simple bill," Howell said. "It simply directs TennCare to apply for a waiver" to impose "reasonable" work requirements.

Republican senators have the companion bill ready for floor consideration in the upper chamber.

The Trump administration has said it is open to work requirements, a departure from previous rules governing the 50-year-old Medicaid program for low-income pregnant women, single mothers with children and some elderly people.

Republicans in a number of states, including Tennessee, are rushing to ask the U.S. Centers for Medicare and Medicaid Services for the waiver.

But the Tennessee bill also asks CMS's parent agency, the U.S. Department of Health and Human Services, for a second waiver of Temporary Assistance for Needy Families funds to help pay for administering the program.

Legislative fiscal analysts had originally projected the state's costs of implementing a work requirement at about $18 million with another $15 million coming from the federal government.

But with the Harwell and Howell amendment added that also asks HHS for permission to use TANF program funds, fiscal analysts said the bill essentially has no fiscal impact at this point because implementation of the waiver is dependent on a favorable decision by the federal government or other federal money.

Democrats questioned Republicans' approach. Democratic Caucus Chairman Mike Stewart of Nashville and Rep. Rick Staples, D-Knoxville, unsuccessfully sought to amend the bill.

While the proposal would not apply to able-bodied women with children under the age of 6, per federal rules, Staples said work requirements could result in mothers having to work at night, leaving their children alone. He unsuccessfully sought to offer an amendment excluding women with children under the age of 12, which was easily tabled by GOP members.

Stewart, who last week accused Harwell, a 2018 GOP gubernatorial candidate, of pushing the legislation as a political "stunt" to get votes, was more measured in his criticisms Monday night.

But he charged the GOP would be requiring people with mental illness or with drug addictions to work or face losing health benefits.

He raised the spectre of drug-dependent adults, warning they would be "wandering around, trying to figure out a way to pay for their opioid addictions. This is a horrible mistake ... in a state that has a problem."

Republican Caucus Chairman Ryan Williams, R-Cookeville, said that was absurd.

While some 1.4 million people now are enrolled in TennCare, some lawmakers say perhaps 20,000 adults ultimately would be affected.

Williams and other Republicans say that if the waivers are approved, the work requirements would be identical to those in the state's Families First program, which state that working 20 hours a week or spending like amounts of time doing community service or attending school qualify for meeting the requirement.

Contact staff writer Andy Sher at asher@timesfreepress.com or 615-255-0550. Follow on Twitter @AndySher1.