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The GOP Wants You To Work For Your Medicaid

If you don’t know what Medicaid is, odds are it’s because you’ve been lucky enough in your life not to need it. So for those fortunate souls, let me begin with a quick primer on Medicaid.

In a nutshell, Medicaid is a federal and state-funded program that helps cover medical costs for low-income individuals and families, many of whom would otherwise be unable to afford health insurance. Like Social Security and Medicare, Medicaid is an integral part of the social safety net, and in many cases it’s the only thing standing between low-income Americans and financial ruin, or death, as a result of untreated conditions.

So, of course, Republicans are chomping at the bit to make it harder to obtain.

Today, the Trump administration issued a policy guidance paper to state Medicaid directors, giving them the green light to impose a work requirement in order for Americans to receive Medicaid. The criteria suggested by the Department of Health and Human Services are fairly straightforward: able-bodied, working-age Medicaid enrollees should work or participate in work-related activity (such as job training) for a minimum of 20 hours per week in order to retain their coverage.

While many Americans support imposing work requirements in order to receive federal benefits, the move is not without its opponents:

It’s also worth noting that the HHS policy guidance is just that: guidance. There is nothing stopping states – particularly GOP-led states with a raging hard-on for cutting down on “entitlements” – from imposing much stricter criteria to qualify for Medicaid.

For example, HHS suggests 20 hours of work or job training a week to qualify, but there’s nothing stopping an individual state from setting their minimum at 25 or 30 hours a week. Or changing their criteria for what qualifies an individual as “able-bodied.” Or changing the upper limits on the definition of “working age.”

Make no mistake, this is exactly what some states will try to do. And when people get upset, they’ll fall back on the GOP refrain of “states’ rights.” But it’s all horseshit.

The Center for American Progress noted last November that imposing work requirements not only does nothing to improve individuals’ long-term job prospects, but that these requirements often leave workers worse off than they would have been without them. (This excellent piece on New York’s Work Experience Program – which saw a welfare recipient die from a heart attack doing landscaping on Gracie Mansion because she was too worried about losing her welfare benefits to ask for a break – explains it well.)

The GOP is trash.


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