Latest news with #IHAWP
Yahoo
3 days ago
- Business
- Yahoo
Governor signs Medicaid work requirements, Opioid Settlement Fund bills into law
Gov. Kim Reynolds, seen here in a file photo from May 2023, signed two dozen bills Friday. (Photo by Kathie Obradovich/Iowa Capital Dispatch) Gov. Kim Reynolds signed more than 20 bills into law Friday, including funding for the state's Opioid Settlement Fund and state-level Medicaid work requirements. The governor has a little more than a week, until June 14, to sign the remaining bills passed during the 2025 legislative session into law. This week, the governor has held events signing multiple measures into law — including the reduction in Iowa's unemployment insurance tax system. On Friday, she signed into law House File 969, a bill expanding the disability and death benefits for first responders like firefighters, emergency medical services responders and law enforcement officer to cover all forms of cancer. This was not the only measure Reynolds signed into law Friday. She released a list of 24 new laws, which include some state spending provisions and other high-profile policies sent to her desk earlier this year. Here are some of the bills signed into law: As discussions — and conflicts — continue over the federal work requirement proposal for Medicaid coverage included in the GOP budget reconciliation bill, Reynolds signed Senate File 615, into law, a measure setting similar work requirements for the Iowa Medicaid program. The requirements for at least 80 hours of work each month would apply to people receiving health coverage through the Iowa Health and Wellness Plan. IHAWP is the state's expanded Medicaid program for low-income people between ages 19 to 64. There are exemptions to these work and reporting requirements for people with disabilities, serious illnesses or injuries, as well as those with children under age 6. SUBSCRIBE: GET THE MORNING HEADLINES DELIVERED TO YOUR INBOX The law directs the Iowa Department of Health and Human Services to seek a waiver to implement these requirements from the federal government. Iowa HHS has already submitted a waiver with a slightly different work requirement plan for IHAWP — one that sets a 100-hour per month work requirement, or for a person to be earn the equivalent in wages to working 100 hours a month at $7.25 per hour, or be enrolled in education or job skills programs to retain coverage. Reynolds said in a statement on the bill signing, 'it is priority of mine to ensure our government programs reflect a culture of work.' 'If you are an able-bodied adult who can work, you should work,' the governor said. 'We need to return Medicaid back to its intended purpose—to provide coverage to the people who truly need it.' Democrats and others critics have said the legislation will cut off health care coverage for eligible Iowans due to additional red tape, leading to a financial hit for rural hospitals and other health care centers. The measure also contains a component that could have lasting impacts for Iowa's expanded Medicaid program: If the federal government allows Iowa to implement work requirements, then later revokes approval, HHS would be directed to end IHAWP. The move to discontinue the program would require federal approval, and if the decision is not approved, Iowa HHS would be asked to pursue implementing an 'alternative plan' under federal Medicaid administration guidelines. After several years of stalled action, Reynolds approved the Legislature's agreement on how to spend money from opioid lawsuit settlements. House File 1038 distributes $29 million from the fund, money obtained in settlements for lawsuits by states against opioid manufacturers, distributors and pharmacies for their roles in the opioid epidemic. For several years, lawmakers in the Senate and House have failed to reach an agreement on how to spend the funds, which are obligated to go to opioid addiction treatment and prevention. But in the final hours of the 2025 legislative session, lawmakers agreed to a system that provides funding for specific organizations and programs that focus on addition treatment, recovery and prevention in fiscal year 2026. In future years, money in the settlement fund will go to Iowa HHS and the Attorney General's office — entities that will then decide how to allocate the money to organizations in the state. HHS will receive 75% of the funding each year and the AG's office will receive 25%. While some lawmakers said they were frustrated with the money going to these state entities instead of being distributed directly by the Legislature, the bill passed with broad bipartisan support as get the funding into Iowa communities. The governor thanked the Legislature for sending the bill to her desk in 2025. 'The opioid crisis continues to impact Iowa families,' Reynolds said in a statement. 'I'm thankful the legislature reached an opioid settlement fund agreement this session to immediately distribute $29 million to providers and appropriate ongoing available funds to support early intervention, prevention, treatment, and recovery.' The governor also signed House File 706, the bill setting higher penalties for violations of open meetings laws and requiring public officials t9 receive training on open meetings and records laws. The bill was brought forward this year after a similar measure was vetoed in 2024 after a last-minute amendment was added that public records advocates had said would lead to unintended consequences. But Rep. Gary Mohr, R-Bettendorf, said adding heightened penalties and more training was still an important measure to pass as a means of addressing violations of these laws in Davenport related to the collapse of a six-story apartment building and alleged violations of open meeting laws in 2023. The bill was also amended in 2025 by the Iowa Senate to include language add two types of records to the state's list of confidential records — security camera footage from the Iowa Capitol and information from state employee identification card access systems. Senate File 175, also signed into law Friday, is a measure modeled after 'Meet Baby Olivia' laws passed in other states. Though Iowa's law does not reference the 'Meet Baby Olivia' video developed by the anti-abortion group Live Action by name, it requires students in 5th through 12th grade human growth and development classes be shown ultrasound video and computer-generated rendering or animations depicting 'the humanity of the unborn child by showing prenatal human development, starting at fertilization.' The bill was amended by the House to include a provision banning materials in school classrooms on fetal development that come from an entity that performs or 'promotes' abortion, or that contracts, affiliates, or makes referrals to organizations that perform or promote abortions. Democratic lawmakers said this ban would mean material coming from reputable organizations and health care providers, like the Mayo Clinic or the University of Iowa Health System, could be excluded, as the ban would not exclude organizations that perform abortions in cases necessary to save the life of the mother. 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Yahoo
14-05-2025
- Health
- Yahoo
Iowa Senate sends expanded Medicaid work requirements bill back to the House
Sen. Mike Klimesh, R-Spillville, spoke May 13, 2025 on the legislation to implement work requirements for Iowa's expanded Medicaid program. (Photo by Robin Opsahl/Iowa Capital Dispatch) The Iowa Senate on Tuesday sent back to the House a bill to implement work requirements for the Medicaid program, although the Iowa Department of Health and Human Services has already requested a waiver from the federal government to implement similar requirements. There are some differences between Senate File 615 and the waiver request announced by Gov. Kim Reynolds in April. The legislative proposal would require people who receive health coverage through Iowa Health and Wellness Plan (IHAWP), the Medicaid coverage available for low-income, able-bodied adults from ages 19 to 64, to work at least 80 hours each month to stay in the program. The HHS proposal sets a higher work requirement of 100 hours per month, and includes other means to retain IHAWP coverage, such as being enrolled in education or job skills programs, or earning the equivalent in wages to working 100 hours a month at $7.25 per hour. Both versions of the proposal contain exceptions for certain groups, including people with disabilities, individuals who are in a substance abuse treatment program for up to six months, and those with children under age 6. While the legislative proposal has a lower monthly work requirement, it also contains a provision that would end the IHAWP program entirely if work requirements are ever approved by the federal government and later revoked. Iowa HHS would be directed to discontinue the expanded Medicaid program if federal law or regulations are changed to exclude work requirements in the future — contingent on the federal government having previously approved Iowa's implementation of these restrictions. Ending IHAWP would be subject to federal approval. If ending the program is not allowed, the state department would be directed to implement an alternative plan. Both the Senate and House have approved this measure, but the House had sent the legislation back to the Senate with an amendment clarifying the language calling for the discontinuation of IHAWP if the federal government revokes work requirement approval, in addition to adding a requirement for HHS to conduct and submit a report to lawmakers on the Medicaid for Employed People with Disabilities (MEPD) program by Dec. 15, 2025 — before the 2026 legislative session. The Senate amended the House's change to remove the language calling for a MEPD report. Sen. Mike Klimesh, R-Spillville, said the report was unnecessary as conversations on this topic will occur 'on a voluntary basis' before the legislature reconvenes in 2026. Democrats criticized the measure, which they said will remove, due to reporting requirements, low-income people who are working and are in need of health coverage. Sen. Sarah Trone Garriott, D-West Des Moines, compared the feedback lawmakers received at the subcommittee meetings discussing IHAWP work requirements to the subcommittee held on the 'Work Without Worry' legislation that proposed removing Medicaid income and asset limits for Iowans with disabilities. While advocates and Iowans who attended at the 'Work Without Worry' bill subcommittee praised the measure for allowing them to return to the workforce without risking the loss of health coverage, people at the subcommittee meeting for the bill setting Medicaid work requirements overwhelmingly spoke against the proposal. 'Everyone who was a local Iowan showing up on behalf of folks with disabilities, children, pregnant mothers, just folks in the population who are low income and struggling — trying so hard to make ends meet — they said this bill will hurt Iowans,' Trone Garriott said. 'It will push people off of their health care. In other states where it's been implemented, legislation like this has just made it harder for people who do qualify to actually get the paperwork done and stay on.' While supporters have said work requirements will help reduce the costs of Medicaid, Trone Garriott said other states that have implemented similar work requirements have not seen significant savings, and that these requirements will raise overall health care costs in the state because it will cause more people to be uninsured. 'We have a growing number of people who are uninsured when measures like this are enacted, and those folks end up seeking charity care at emergency rooms and hospitals,' she said. 'Charity care is not free. A health care provider needs to spread out the cost, shift those costs on the other folks in order to keep paying the bills and keeping their doors open. It raises costs on everyone when folks are not insured.' Senate Minority Leader Janice Weiner also said the legislature is moving forward with this measure 'without having any firm idea what the fiscal impact will be.' The Legislative Services Agency fiscal notes on the bill stated the nonpartisan agency did not receive responses to multiple requests for information from HHS about the financial impact of implementing work requirements. Klimesh said HHS has included fiscal impact estimates in its waiver request over a demonstration period of five years that have found a cumulative savings of $50 million for the state, and held public hearings on the proposal, a part of the process of seeking approval from the federal Centers for Medicare and Medicaid Services. Klimesh also pointed to movement by the U.S. Congressional Committee on Energy and Commerce to make federal changes to Medicaid which includes requirements for able-bodied people between ages 19 to 65 to work, attend educational programs or participate in community service for at least 80 hours a month to stay eligible for coverage. 'Essentially, if you look at the blueprints the federal government is utilizing, it almost lines up specifically with what the state's requirements are,' Klimesh said. The bill was approved as amended in a 33-13 vote, and returns to the Iowa House.
Yahoo
23-04-2025
- Health
- Yahoo
Iowans express frustration, concern about state plan for expanded Medicaid work requirements
From left: Terry Anderson, Heather Sanders and Robbin Mensching raised their hands to make comments or ask questions of Iowa Department of Health and Human Services staff about the state's proposal to add work requirements to the state's expanded Medicaid program, Iowa Health and Wellness Plan, during a public comment session hosted at the Urbandale Public Library April 23, 2025. (Photo by Robin Opsahl/Iowa Capital Dispatch) Iowans stressed the importance of health coverage and the difficulties of obtaining government recognition of medical conditions at the first public comment session on state's effort to add work requirements to its expanded Medicaid program. The Iowa Department of Health and Human Services is seeking a waiver from the federal government allow it to implement work requirements for the Iowa Health and Wellness Plan, or IHAWP. The public hearing Wednesday at the Urbandale Public Library was the first of three meetings for public comment required by the waiver submitted to the U.S. Centers for Medicare & Medicaid Services. IHAWP is the Medicaid expansion program signed into law by former Gov. Terry Branstad, a Republican. It provides public health insurance for low-income Iowans at or below 133% of the federal poverty level who do not qualify for regular Medicaid coverage — people between the ages of 19 to 64 who do not have a disability. SUBSCRIBE: GET THE MORNING HEADLINES DELIVERED TO YOUR INBOX The waiver, announced by Gov. Kim Reynolds earlier in April, proposes requiring IHAWP recipients to work 100 hours per month to remain eligible for coverage. There are other ways to meet this requirement — a person can continue receiving state health coverage if they are enrolled in an education or job skills program, or if they earn the equivalent in wages to working 100 hours a month at the state minimum wage, $7.25 per hour. There are some exceptions for the work requirements. People who are considered medically frail or medically exempt under Medicaid would not have to meet the work requirements, nor would individuals caring for a child under age 6, who have a high-risk pregnancy, or are in substance abuse treatment programs for up to six months. The waiver request also states that individuals who 'provide proof of good cause as defined by HHS' would be exempt, but did not include details on what standards would be used by the state department for assessing these claims. At the hearing, several speakers talked about their own experiences or time helping others applying for public assistance coverage under the current Medicaid program. Nancy Lynch of Des Moines, a former school social worker, said she worked with parents of children with disabilities who were denied services and assistance — and said she believes work requirements would add another hurdle for people in need accessing health coverage and care. 'My job was to help support parents who had children with very special needs that needed help — needed help with health care, needed help with services — and I saw how difficult it was for them to receive those services,' Lynch said. 'No one got it on the first time. Everybody had to apply three and four times. They'd say the same thing, but they had to reapply and reapply and reapply. So they had to kind of beat down the system until they were finally accepted. … And my big concern is that these work requirements will add more barriers to people who need these services, they will lose the support they need.' Robbin Mensching of West Des Moines said she was concerned about how HHS would assess mental illnesses and provide exemptions. Speaking about her own experience struggling to receive an official diagnosis of having a mental illness, she said it can be difficult for people with mental health issues to be recognized as having a medical issue. After receiving care, Mensching said she was able to more fully participate in life, but that denying that coverage could impact people's ability to join the workforce or care for their families. 'I want to know how they're going to handle covering these people, because there are a lot of people that have been like me,' Mensching said 'Anxiety, depression, panic attacks — it's disabling.' Work requirements would be enforced through reporting. HHS stated that people on IHAWP would be required to report information showing the work requirements were met every six months. The department plans to create a mobile application for IHAWP members to submit required information showing their compliance with the work requirements if HHS does not already have the information available. If the required information is not provided, the individual's coverage would be suspended. Mary Nelle Trefz, the advocacy network director of Iowa ACES 360, called for the state to share information about the cost of implementing work requirements, pointing to the need for the Iowa state government to create a new information technology system and train staff to implement and support the reporting requirements. As Reynolds and HHS pursue a waiver for implementing work requirements, the Iowa Legislature has also moved this session to pass a bill implementing expanded Medicaid work requirements. There are some differences between the HHS and legislative policies — the bill proposes an 80-hour monthly work requirement, and includes 'trigger' language that would require the state to end IHAWP coverage for all recipients if the federal government revokes work requirements in the future after they were approved. The legislation also includes an appropriation of roughly $8.2 million, according to the Legislative Services Agency, to set up the needed IT system for administering reporting requirements under the proposal. The funding to create this IT system is not a part of the HHS waiver request, Trefz said. 'That pending legislation also included support for IT, funding for that — but that legislation has not passed yet,' Trefz said. 'Those dollars have not been appropriated. So how will the state ensure the necessary infrastructure is in place?' Multiple speakers expressed frustration that the HHS staff who hosted the meeting did not answer several of the questions or direct responses from HHS or other state leadership posed about certain details of the policy or how it would be implemented, or if there would be changes made to address any of their concerns. Staff at the meeting said the comments and questions would be shared with state leaders, and would be used to answer questions about work requirements in future communications. Mensching said she felt work requirements were already a 'done deal' in Iowa, but said she believed it was important for Iowans — especially those who would be impacted by the change — to speak out. 'I would have ended up living on the street at one point in my life (without health coverage), and then you've got all these other things that go with that — somebody getting health care for me, the police would be involved — I mean, it just goes on and on,' Mensching said. 'It's so much more efficient and humane to just give people coverage so that they can live a normal life.' Trefz, alongside Stacy Frelund with the American Heart Association, said they were creating a 'protect Medicaid' coalition to coordinate organizing efforts to oppose the new work requirements. There will be another public hearing held on the waiver request, on April 29 at 2 p.m. at Marshalltown Public Library. Comments can also be submitted through email and by mail through May 15, with information available on the public notice website for the waiver. SUPPORT: YOU MAKE OUR WORK POSSIBLE
Yahoo
15-04-2025
- Health
- Yahoo
Gov. Kim Reynolds seeks federal waiver for Medicaid work requirements
Gov. Kim Reynolds announced April 15, 2025, the state Department of Health and Human Services was seeking a federal waiver to implement work requirements for Iowa Health and Wellness Plan (IHAWP) recipients. (Photo by Robin Opsahl/Iowa Capital Dispatch) Gov. Kim Reynolds announced Tuesday the state has submitted a waiver to the federal government to implement work requirements for Iowans on the state's expanded Medicaid program. The governor directed the Iowa Department of Health and Human Services to seek a waiver to the U.S. Centers for Medicare & Medicaid Services for work requirements, according to a Tuesday news release — an effort she announced she would take action on at the beginning of the 2025 legislative session. The news release Tuesday stated the waiver reflects the legislation being considered by Iowa lawmakers, Senate File 615. The bill has been approved by both chambers, but the Senate must approve an amendment from the House before it goes to the governor. SUBSCRIBE: GET THE MORNING HEADLINES DELIVERED TO YOUR INBOX The Iowa Health and Wellness Plan, or IHAWP, the state's expanded Medicaid program, provides health coverage to able-bodied Iowans from ages 19 to 64 with household incomes at or below 133% of the federal poverty level. There are exceptions to the proposed work requirements, including for people who are considered medically frail or medically exempt under Medicaid , adults caring for a child under age 6 and people in substance abuse treatment programs for up to six months. The bill proposes that non-exempt IHAWP recipients work at least 80 hours each month to be eligible for health coverage. According to the Iowa HHS proposal, the governor's waiver proposal sets a 100-hour per month requirement for individuals to remain eligible for coverage. If the federal waiver is rejected under the legislation, the state would be required to end the expanded Medicaid program for all recipients, regardless of whether they are working. Reynolds said in a statement that she has prioritized ensuring Iowa's government programs 'reflect a culture of work.' 'If you are an able-bodied adult who can work, you should work,' Reynolds said. 'We need to return Medicaid back to its core purpose — to provide coverage to the people who truly need it.' The state estimated that nearly 100,000 individuals currently on IHAWP report having no income, according to the governor's news release. The Legislative Services Agency estimated 142,000 of the 181,000 Iowans currently on IHAWP would be subject to work requirements under the Medicaid work requirements bill, and that 32,000 Iowans would likely lose the health coverage if the legislation is implemented. Democratic lawmakers have argued work requirements will result in higher costs to the state, by pushing health care costs from low-income individuals currently on IHAWP to other areas of the state's health care system. There will be two public hearings for the waiver — the first at Urbandale Public Library on April 23 at 10:30 a.m., and the second at Marshalltown Public Library on April 29 at 2 p.m., with both meetings available for remote access via Zoom. SUPPORT: YOU MAKE OUR WORK POSSIBLE
Yahoo
27-03-2025
- Health
- Yahoo
House sends expanded Medicaid work requirements bill back to Senate
Rep. Carter Nordman, R-Adel, spoke in support of enacting work requirements for Iowa's expanded Medicaid program during floor debate March 26, 2025. (Photo by Robin Opsahl/Iowa Capital Dispatch) The Iowa House sent the bill imposing work requirements on recipients of Iowa's expanded Medicaid program back to the Senate Wednesday. Senate File 615 was approved by the House 61-35 with some changes. The bill, which passed in the Senate Tuesday, would require people receiving health insurance through Iowa's expanded Medicaid program known as IHAWP, or the Iowa Health and Wellness Plan, to work at least 80 hours each month to be eligible for coverage. IHAWP coverage is available to able-bodied Iowans from ages 19 to 64 who have household incomes at or below 133% of the federal poverty level — roughly $20,030 in annual income for a single individual and $27,186 for a household of two. Rep. Carter Nordman, R-Adel, the bill's floor manager, said Medicaid is intended to serve individuals with disabilities and with very low incomes. However, he said currently 'more able-bodied adults are accessing Medicaid benefits without the requirement of work' through the IHAWP program. 'While Medicaid expansion has been a vital safety net, it is not meant to be a permanent solution,' Nordman said. 'We want to help individuals transition off the reliance of government and into a position where they can thrive independently. Requiring work is a key part of that transition.' According to analysis by the Legislative Services Agency, roughly 142,000 of the 181,000 Iowans currently enrolled in IHAWP would be subject to work requirements under the bill when accounting for medical exemptions and other caveats provided in the legislation, like exemptions for people with children under age 6 and in substance abuse treatment programs for up to six months. Of the people who would be required to work 80 hours a month — and report this information to the state to continue receiving care — LSA estimated that 32,000 Iowans would lose IHAWP coverage if the bill is implemented. This figure was calculated using data from Arkansas, a state that previously implemented Medicaid work or community engagement requirements. Rep. Austin Baeth, D-Des Moines, said the bill will deprive low-income people of health care and coverage using a false argument that there are a large number of people receiving Medicaid coverage who are choosing not to work. He cited a study from the Kaiser Family Foundation that found 92% of adults under age 65 who did not receive benefits through other programs like Social Security or Medicare were working full or part time, or were not working because of caregiving responsibilities, school or due to an illness or disability. Baeth said the bill sends a 'cynical message that people in poverty are lazy' and will take away health care coverage from working Iowans who do not have the time or resources to meet the reporting requirements that would be implemented under the bill. 'Hardworking people are too busy working their jobs, trying to make rent, trying to put food on the table, not watching the news (to know) that they have to go to a particular website by a particular amount of time to press some particular button,' Baeth said. 'That's how people fall through the cracks. And when they fall through the cracks, in this particular case, it can be the matter of life or death.' A major point of contention for Democrats on the bill was language that directed the Iowa Department of Health and Human Services to discontinue IHAWP if the federal government does not approve work requirements for the program. The House amended the bill to clarify that this 'trigger' language to seek federal approval for ending IHAWP would only apply if the implementation of work requirements has been federally approved and later revoked. If the federal government does not allow the state to end the Medicaid expansion program, the bill would direct Iowa HHS to pursue implementation of an 'alternative plan' acceptable under federal Medicaid administration guidelines. Nordman said the language on discontinuing IHAWP without work requirements was to avoid making Medicaid policy changes in Iowa contingent on who is in the White House. 'The reason why this is in there is we are not going to play this back-and-forth game with the federal government that would disallow us to do it every four years, and then we do it another four years, and then four years later we're not allowed to do it,' Nordman said. '… Just to make it clear, if this is approved by the Trump administration, as I believe it will be, the only reason why Medicaid expansion in the state would go away is because of a Democrat president.' Rep. Timi Brown-Powers, D-Waterloo, questioned how these changes would be implemented by HHS, pointing to the fact that the department has a 'pause' on hiring for new positions. LSA, a nonpartisan agency, noted that the Iowa Department of Health and Human Services had not responded to multiple requests for information on the fiscal impact of implementing work requirements, but estimated that the bill would result in $3.1 million in decreased Medicaid expenditures for fiscal year 2026 and $17.5 million in FY 2027. Iowa HHS has not responded to requests for comment on why information was not shared with LSA or lawmakers who said they had made requests. Brown-Powers said the department has also not shared figures on Medicaid waste, fraud or abuse occurring through IHAWP that would be addressed through work requirements. She said unless HHS data shows there is a substantial number of people misusing the expanded Medicaid system, the costs of implementing the bill will outweigh money saved. 'And guess what? We don't have a lot of money,' Brown-Powers said. 'We're already dipping into the funds to pay the bills. So how are we going to pay for this? Where are the (full-time employees) going to come (from) to monitor this? How are we going to assure Iowans that they're not going to lose their insurance?' Nordman said that in Iowa 'it is estimated that more than 100,000 able-bodied people on Medicaid expansion are not working … to their capacity or what they should be.' The bill also directs Iowa HHS to seek federal approval to implement work requirements for public assistance programs like Supplemental Nutrition Assistance Program (SNAP). SNAP recipients who are able-bodied adults with no dependents already are required to work, volunteer or participate in work programs for at least 80 hours a month to receive benefits. The House passed another bill Wednesday related to SNAP benefits that proposes a new $1 million appropriation to the food stamps program to the Double Up Food Bucks program, allowing recipients to double SNAP dollars for fresh produce purchases. However, the bill makes the additional funding contingent on the federal government approving restrictions on what foods are available for purchase through SNAP to only include healthful foods 'based on necessary nutrition for good health.' The House sent the legislation back to the Senate with some changes, including the language clarifying IHAWP federal approval contingencies as well as a new section requiring Iowa HHS to conduct a review on the Medicaid for employed people with disabilities program. The department would be directed to look at issues like eligibility criteria, asset limits and cost-sharing requirements in other states' programs over the 2025 interim and deliver a report to lawmakers by December with recommendations on how to expand employment opportunities for people with disabilities on this Medicaid program. The bill also includes a provision to raise the amount of available resources that a married couple receiving coverage through the Medicaid for employed people with disabilities program can have from $13,000 to $21,000. Individuals with disabilities on this program would still have the $13,000 asset limit if they are single. The amended bill must be approved by the Senate before it would go to Gov. Kim Reynolds for final approval. A spokesperson for the governor said Tuesday that the governor has directed HHS to submit a federal waiver for Medicaid work requirements independent of the legislation 'which will be done soon.'
