SALYERSVILLE, Ky. (WKYT) - As Kentucky moves to become the first state with a work requirement, finding work in many counties isn't easy and enforcing the new rule will be a tough task for state officials.
"I would not be truthful if I didn't say it's a big challenge,"said Kristi Putnam, Medicaid waiver program manager for the state . "It's a big project. There are a lot of moving parts and lots of partnerships."
The federal government recently said it would let Kentucky be the first state to require many of its Medicaid recipients to have a job or do volunteer work in order to keep their health coverage.
A WKYT analysis found the latest unemployment rate numbers were above the state average in each of the ten counties with the highest percentages of Medicaid recipients.
With 82 percent of its population receiving Medicaid in January, Marshall County topped the list.
Magoffin County followed with 75 percent of the county's population receiving Medicaid. Combine that with an unemployment rate of 12.4 percent or three-a-half times the state average, and it's easy to see why there's concern.
"We got here because the federal government decided in the 1960s to give food stamps and welfare to everybody that was under a certain threshold," Salyersville Mayor Pete Shepherd told WKYT's Miranda Combs.
Shepherd says changes in the coal industry added to the number on Medicaid, by emptying tons of jobs in the county years ago.
"At that time, when the coal went out, we had a lot of people that went off good-paying jobs to nothing," Shepherd said. "It's not their fault, and a lot of them would work if there were jobs available."
With those challenges, the mayor said he had concerns when the state announced the new Medicaid program with requirements for people to work, volunteer or go to school for them to receive benefits.
"You can't make jobs if there's nothing there to have for jobs," Shepherd said.
The work requirement isn't without legal challenges either. On Monday, Gov. Matt Bevin's administration filed its own lawsuit after three nonprofit groups sued the federal government, asking a judge to block Kentucky's Medicaid waiver granted by the Trump administration.
Putnam, who's working to get the state program up and running, believes there's been a lot of misinformation about the program.
"It's really intended to help connect people to resources so that they aren't in the multi-generational poverty situation and not depend on benefits," Putnam said.
She estimates about 239,000 people in Kentucky will have the "community engagement requirement," meaning they will need to work, take classes or volunteer. However, she said half of those people already meet the requirement.