The real reasoning behind Medicaid work requirements


March 9, 2018

Back in January, I wrote a piece for this blog about a move by the Trump administration to allow states to impose work requirements for Medicaid recipients. Since then, three states – Kentucky, Indiana, and Arkansas – have received federal approval to allow them to establish work requirements for adult Medicaid recipients to be eligible for health coverage. At least seven other states have submitted similar requests to impose such requirements, and more are considering the idea.
Arkansas’s Governor Asa Hutchinson said about the requirements, “This is not about punishing anyone. It’s about giving people an opportunity to work. … [I]t’s to help them to move out of poverty and up the economic ladder.” But advocates – and the public – see right through that. In fact, a poll from the Kaiser Family Foundation found that, when asked what they think the reasoning is behind these proposed changes to Medicaid, a larger share of the public (41 percent) believe the main reason is to reduce government spending by limiting the number of people on the program, while only 33 percent say the main reason is to help lift people out of poverty. Even Republicans were almost evenly split on the goal of these proposals; see the graph at the end of this blog for the breakdown of the responses to this question by party affiliation.

We know that proposals to add work requirements are really just a way to push people off programs that help provide basic living standards, in part to pay for things like the bill Congress passed last December to give massive tax cuts to the wealthy and corporations. We also know that work requirements don’t work. They didn’t move people out of poverty in Kansas when the state tied them to TANF assistance. Instead, work requirements may have the opposite effect; by taking away health care, they will make it harder for people to stay healthy and continue working, further threatening their financial security.

While proponents of these proposals claim that people with disabilities won’t be affected, our friends at the Arc know that,

“For nearly 5 million people with disabilities, a work requirement could mean less coverage, worse health and, ironically, fewer chances to find or keep a job.”

We also know that work requirements on Medicaid will harm people with mental health conditions. Similar proposals to allow work requirements to be added to housing assistance and to make harsher already-existing work requirements on SNAP/food stamps will similarly harm families, including many workers and children.

A subcommittee of the House Education and Workforce Committee is holding a hearing on work requirements and welfare programs on Thursday, March 15 at 10 a.m. ET. You can watch a live stream of the hearing here. If you have the chance to watch the hearing, please share your thoughts about it in the comments section below, or share what you would like to see at the hearing.

Access to medical care is critical to keeping people healthy, which allows them to work as they are able. To learn more about Medicaid work requirement proposals being tracked in the states, click here. For statements, infographics and other resources related to work requirements, check out CHN’s Protecting Basic Needs Programs webpage.

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