Why Forcing Medicaid Recipients to Have a Job Is a Horrible Idea

On Thursday, March 23, the House is expected to take a vote on the American Health Care Act – the Paul Ryan medical bill developed to kill and replace Obamacare. Despite years of working on an Affordable Care Act replacement, the GOP masterplan still remains fuzzy around the edges, and it’s unclear what will still change as Republicans attempt to push it through Congress.

One new plank that may be included now, according to recent reports, is a rule that would allow states to deny Medicaid coverage to any person who would otherwise qualify based on his or her income if that person is not working at least 20 hours each week. If so, that would in effect be a back door dismantling of the program, since it would all but make Medicaid coverage completely disappear in many states across the U.S.

“House Republican lawmakers from different factions of the caucus say they are open to adding Medicaid work requirements to their ObamaCare replacement bill, a measure that could help bring conservatives on board without alienating moderates,” The Hill reports.

It adds, “There is some difference of opinion, though, as to whether the change should only allow states to require Medicaid recipients to work, or whether it should go further by requiring states to make the change. [House Freedom Caucus Chairman Mark Meadows (R-N.C.)] said he wants the work requirements change to be mandatory. Rep. Morgan Griffith (R-Va.) has a measure to just allow states to make the change. There is also a question as to whether work requirements could pass muster under Senate rules for the fast-track reconciliation process.”

Like many other demands for some sort of work requirement in order to be allowed government aid – such as for welfare benefits or food assistance – GOP supporters are claiming that their goal is to ensure the recipients aren’t made unambitious due to over reliance on federal handouts. Such Republican stereotypes about the poor ran rampant at the House hearing, according to the Washington Post.

“The sharpest exchange during the committee’s debate was over making able-bodied adults on Medicaid hold or train for a job. Republicans suggested that such a requirement would save the government money and foster self-reliance. ‘Let’s prevent idleness,’ said Rep. Jodey Arrington (R-Tex.), who contended that requiring people to work would ‘make this not so much of a seductive entitlement,’” the Post reported. “Rep. Jan Schakowsky (D-Ill.) countered, saying that ‘most people on Medicaid who can work, work’ and that Republicans’ ‘ultimate goal is to simply kick people off Medicaid and not actually help people find employment.’”

Republicans may be insistent that a work requirement is in the best interest of Medicaid recipients, forcing them to be self-reliant and “not idle,” but public policy experts soundly pan the idea. Much like other aspects of government programs being tied to work requirements, there has been little evidence that the requirement actually helps those who aren’t working to find or hold a job, and unlike other benefits, denying a person health insurance will make their health decline even more, not only making it even more difficult to find work, but add those costs back to the government through increased emergency care down the road.

In fact in most cases, it’s a solution in search of a problem. “The premise of imposing a work requirement is that people who aren’t working have chosen to be unemployed. But the disappointing track record of work requirements in failing to increase stable employment over time suggests that most people who can work do so and that for people who face major obstacles to employment, work requirements do not help to overcome them,” the Center on Budget and Policy Priorities explained in June of 2016, the last time an ACA repeal and replace bill went through Congress. “The data indicate that most Medicaid beneficiaries who can work already do so. Three-quarters of non-elderly adults and children enrolled in Medicaid live in a family with at least one worker. (In California, in fact, Medicaid covers 10 percent of all full-time workers in the state and 20 percent of all part-time workers.)”

Simply put, there are only two scenarios that would occur if a work requirement was added to the Medicaid during the passage of the AHCA.

In the first scenario, a requirement would be added that could not be met by those who are pregnant or raising children, who are in school, who are early retirees waiting the last few years for their Medicare coverage to begin, or who simply are unable to find work for whatever reason. These vulnerable populations would then be uninsured, avoiding necessary healthcare services until their health declines and their illnesses become more burdensome, expensive and unavoidable.

The second is that there would be enough loopholes – the requirement is waved if you are over 60, or a family caregiver, or are in school or undergoing training, and so on – to the point where the “requirement” would be utterly toothless in effect.

In other words, once more the GOP is proposing something to appeal to its base that it has no real desire to follow through on. In fact, that sounds quite a bit like the Obamacare replacement plan in the first place.

Photo credit: Thinkstock

121 comments

Marie W
Marie W1 years ago

Thanks for sharing.

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Sarah H
Sarah Hill2 years ago

Many of those who receive Medicaid, Welfare & food stamps are able to do some form of work, and they should.

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pam w
pam w2 years ago

TO BRIAN F AND RHOBERTA.....could you take this snipe-fest to a private room somewhere?

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Jessica K
Jessica K2 years ago

There is also the reality that this proposal would mean more government interference in private enterprise, at least in the ancillary effect of oversight to monitor employment hours. Thanks.

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Rhoberta E
Rhoberta E2 years ago

brian f
Yada, yada, yada !!!
It seems in the contributing to this website area, you reached YOUR peak months ago

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Brian F
Brian F2 years ago

Rhoberta E You really have nothing to contribute to this website. You hate true progressives like Jill Stein and Bernie Sanders. We get it, but when you defend your crook and liar Hillary who got 21 million from Wall Street for speeches, and 13 million from our criminal healthcare industry, and refused to support single payer universal healthcare, you come off as a liar. At least I support true progressives like Bernie Sanders and Jill Stein who have policies this country badly needs, instead of crooks and liars like Hillary who you support, and I don't dent the obvious corruption in the democratic party, like you do.

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Rhoberta E
Rhoberta E2 years ago

brian f
The fact that you are still pouting over YOUR loss at YOUR polls, isn't my problem.
I guess you have to TRY and go after those who DID vote for trump.
You won't get there by doing what you're doing. NO one is listening to you being stuck in the past.. Work on the future in a POSITIVE way !!! Your cut and paste is long beyond it's expiry date. You'll STILL be whining come 2018 or 2020

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Brian F
Brian F2 years ago

Rhoberta E We don't have single payer universal healthcare here because big pharma and our criminal healthcare industry makes billions in profits, and own our venal politicians. Hillary who you so staunchly defend, is against single payer universal healthcare and instead wants to expand on Obamacare which still leaves the criminal healthcare industry to much power. Hillary supported single payer universal healthcare in 1994, until our criminal healthcare industry paid her 13 million dollars to buy her support. If anyone is braindead, it must be you for supporting your queen of corruption, Hillary who is in the pockets of Wall Street and our criminal healthcare industry, instead of the true honest progressive I support, Bernie Sanders, who supports single payer universal healthcare with a public option, or Medicare for All, similar to what you have. Since you hate our horrible corrupt healthcare system so much, why do you support corrupt politicians like Hillary who are paid healthcare industry shills, instead of supporting true honest progressives like Bernie Sanders, who supports single payer universal healthcare with a public option, which we desperately need in this country. If you really want to help our country, you should support true honest progressives like Bernie Sanders or Jill Stein instead of corrupt corporate democrats like Hillary.

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Rhoberta E
Rhoberta E2 years ago

brianf
Are you brain dead ????
I'm a LIBERAL CANADIAN !! I VOTE in CANADA !! I HAVE Single payer health, extended benefits WITH Rx coverage. I DO work with our politicians to make sure your idiotic policies about most things don't find their way here..
I have ONLY told you this maybe 100 times???. YOU are the "Wayne Whiner"

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Brian F
Brian F2 years ago

Rhoberta E I'm getting sick of your whining and constant defense of the corrupt corporate controlled democratic party that's as corrupt and corporate owned as the republicans, and blocking true progressives like Bernie Sanders from having any power so they can continue their corruption, and make millions from Wall Street, banks, big pharma, and corporations. Support true progressives like Bernie Sanders if you want to help our country. Get off your butt and start supporting true progressives like Bernie Sanders or Jill Stein, or stop commenting here.

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