Three Reasons Congress Should Reject Medicaid Work Requirements

(and the hatred for the less-advantaged continues. The graphs are at the link below)

(and I apologize for that slimeball's image for this article)


Three Reasons Congress Should Reject Medicaid Work Requirements
5/4/2023 by Thomas Waldrop, Kimberly Knackstedt and Rebecca Vallas


Calls to include work reporting requirements in the eventual debt ceiling bill are directly counter to the purpose of the Medicaid program.



House Speaker Kevin McCarthy (R-Calif.) speaks to the media at the U.S. Capitol on April 26, 2023, after the House passed a bill raising the nation’s debt ceiling. The bill also includes sweeping spending cuts over the next decade. It’s not expected to pass the Senate, and President Joe Biden would veto it if it did. (Tasos Katopodis / Getty Images)

This commentary was originally published by The Century Foundation.

On April 26, the House passed Speaker Kevin McCarthy’s debt ceiling bill, the “Limit, Save and Grow Act.” If enacted, the bill would create new work reporting requirements, stripping Medicaid coverage from adults unable to document eighty hours of work or community service per month. Work reporting requirements are unnecessary, harmful and ultimately counter to the goals of the Medicaid program. Here’s why.


Most Medicaid beneficiaries already work.

Medicaid is a joint federal–state public insurance program that provides health coverage to low-income people, many of whom are disabled and qualify through their disability status. Proponents of work reporting requirements for Medicaid argue that they promote “personal responsibility” among Medicaid beneficiaries. This approach is both insulting to Medicaid beneficiaries and represents a solution in search of a problem. According to a recent analysis of Census Bureau data by the Kaiser Family Foundation, more than 60 percent of non-elderly Medicaid beneficiaries who did not qualify for the program through supplemental security income enrollment worked at least part-time. The same analysis found that of the remaining enrollees, the overwhelming majority of those would likely qualify for one of the exemptions in the House GOP bill:

13 percent were not working due to caregiving responsibilities,
11 percent were not working due to illness or disability, and
6 percent were not working due to school attendance.

The remaining 9 percent of Medicaid enrollees who were not working at the time is a broad group, including both retirees and people who were unable to find work.

Figure 1 shows the makeup of work status among Medicaid beneficiaries:

Page 1
WORK STATUS AMONG NONELDERLY, NONDISABLED MEDICAID BENEFICIARIES, 2021
Chart
43%18%13%11%6%9%
Working Full-Time
Working Part-Time
Not Working Due to Caregiving
Not Working Due to Illness or Disability
Not Working Due to School Attendance
Not Working Due to Retirement, Inability to Find Work, or Other Reason
Source: Kaiser Family Foundation analysis of March 2021 Current Population Survey data, https://www.kff.org/medicaid/issue-brief/understanding-the-intersection-of-medicaid-work-a-look-at-what-the-data-say/.
Image



. . . . . .

Figure 2 shows the proportion of Medicaid renewals that states report completing through administrative data:





. . . . .


Hundreds of 1199S EIU healthcare workers staged a rally to block 3rd Avenue in New York City, a protest against healthcare cuts in Gov. Kathy Hochul’s budget on Medicare. (Lev Radin / Pacific Press/LightRocket via Getty Images)


. . . . .


First, work reporting requirements are rooted in the racist ideology that Black women and other low-income people of color are lazy and do not value work. This idea is decades old and has fueled work requirements in many public assistance programs. During the passage of the law establishing the Temporary Assistance for Needy Families (TANF) program, much of the discussion focused on Black mothers, described as needing a “stick” to encourage them to work. The idea is present in this present bill: Speaker McCarthy described the goal of Medicaid and other public assistance programs as “a hand up, not a handout.” In addition to their racist origins, work reporting requirement implementation methods have been proposed in racist ways in the past. When Michigan proposed its work reporting requirements in 2018, for example, the bill would have exempted counties with unemployment rates above 8.5 percent. While this seems like a sensible exemption to address areas of the state with limited employment opportunities, it functionally carved out counties with higher Black populations, even if those counties still had substantial unemployment rates. Genesee and Wayne Counties, home of Flint and Detroit, respectively, both had employment rates of more than 5 percent, but would not have been exempted from the work reporting requirement.



. . . . .



Congress should reject work reporting requirements.

As Congress determines the legislative vehicle for raising the debt ceiling, it should reject calls to include work reporting requirements in the eventual bill. These requirements are directly counter to the purpose of the Medicaid program, and imposing these requirements on beneficiaries will only result in low-income individuals and families—including significant numbers of people with disabilities—losing critically needed health coverage and services. Achieving universal coverage is essential to achieving health equity, and these requirements would be a dangerous step backward in achieving that goal.


https://msmagazine.com/2023/05/04/debt-ceiling-medicaid-work-requirements/