Medicaid: Requiring enrollees to work
The Trump administration is about to embark on a much-needed “Medicaid experiment,” said the New York Post in an editorial. For the first time in the program’s 50-year history, the federal government has agreed to grant waivers allowing states to impose “modest” work requirements on some Medicaid recipients. Beginning in Kentucky, with nine other mostly red states lining up to participate, any enrollees who are able to work—excluding pregnant women, children, the disabled, and the elderly—will now be expected to get a job, do some volunteering or training, or prove they are caregivers. “It’s about time,” said John Daniel Davidson in TheFederalist.com. Medicaid’s original purpose was to provide health care to “strictly defined groups,” including poor kids, the blind, and the disabled. Obamacare transformed the program into a sprawling entitlement covering 11 million more people—including “able-bodied, childless adults of working age.”
“Don’t be fooled,” said Judy Solomon in CNN.com. Team Trump would have you believe this move is about incentivizing work. Yet “Medicaid beneficiaries who can work, do work.” About 80 percent of able-bodied enrollees work or have spouses who work in jobs without medical benefits; they rely on Medicaid to stay healthy enough to keep working. The rest are low-income individuals who suffer from a mental or chronic illness, are in school, take care of family, or simply can’t find a job. Those vulnerable Americans will be left without health care when they can’t meet new bureaucratic requirements. That’s the real motive for Republicans, said Paul Waldman in TheWeek.com. Small-government conservatives see kicking people off Medicaid as a “good outcome”—and to justify this approach, they need to paint recipients “as undeserving, slothful moochers.”
Here comes another legal battle, said Amy Goldstein in The Washington Post. Under the law that created Medicaid, waivers can only be granted if they “assist in promoting the objectives” of the program—that is, providing health care to low-income people. The Trump administration is trying to get around that requirement by stating that “productive work and community engagement may improve health outcomes” more than simply being able to see a doctor. Liberal advocacy groups doubt that rationale will survive legal review, and vow a challenge. Like so many other policies the Trump administration has tried to push through, this one is headed for the courts.