Medicaid Work Requirement Is A Solution For A Problem That Doesn't Exist

 The following is part of a post by Matt Bruneig in The New York Times:

House Republicans have proposed adding work requirements to Medicaid, the health insurance program serving tens of millions of low-income Americans. Their plan, unveiled Sunday, would, with a few exceptions, strip coverage from childless adults who cannot document at least 80 hours of monthly employment. . . .

Imposing work requirements on Medicaid is a fundamentally misguided policy. In the debate over work requirements, it is easy to get sucked into abstract moral theorizing about what a society owes people who can work but refuse to do so. This sort of philosophizing is interesting, but it tends to elide the fact that it is employers, not workers, who make hiring, firing and scheduling decisions.

Last year, over 20 million workers were laid off or fired at some point from their jobs. Many of those workers ended up losing not just all of their income but also their employer-sponsored health care. Medicaid is supposed to provide a backstop for these workers, but if we tie eligibility to work, they will find themselves locked out of the health care system because of decisions their employers made, often for reasons beyond their control.

Even workers who are able to get and keep jobs do not decide how many hours they are scheduled for. Many low-wage employers assign shifts based on real-time estimates of consumer demand, resulting in unpredictable work hours for their employees. Through no fault of their own, these workers frequently see their schedules drop below 80 hours a month. The resulting income instability creates significant hardships for them. Eliminating their health insurance would only make things worse. . . .

There is not an epidemic of non-working able-bodied adults living high on Medicaid, despite such claims from the Trump administration. Medicaid work requirements are a solution to a problem that doesn’t exist. According to the Census Bureau’s current population survey, around 46 percent of Medicaid beneficiaries are children or people age 65 or older, age groups that are not expected to work.

Of the working-age beneficiaries, about half are working, and an additional quarter have a work-limiting disability. An additional one-fifth will work at some point in the next year or come off Medicaid sometime in the ensuing 15 months. This means that only 6 percent of working-age enrollees are not engaged in work long term, which is just 3 percent of the entire Medicaid population. . . .

For those fundamentally opposed to Medicaid and the welfare state more generally, the fact that these new requirements would create administrative barriers that disenroll eligible recipients may be seen as a feature, not a bug. I suspect that for many of the Republican policymakers who endorsed work requirements, the goal of such a policy isn’t genuinely to increase employment or remove support from only those who refuse to work. Rather, it is to redirect resources from lower-income Americans toward those at the top. And for that purpose, it is indeed well designed.