Republicans have long championed work requirements as a condition for able-bodied adults receiving Medicaid. The logic goes: why should taxpayers help you if you are unwilling to help yourself?” Work requirements are controversial, but they probably should not be. The New York Times reported that Republican’s support for Medicaid is much stronger when recipients must work for it. Democrats generally oppose any kind of preconditions for entitlement programs.
Earlier I wrote about a program in Georgia, the only state with a work requirement. The program is off to a slow start. On the one hand, few people have taken advantage of the program, which requires eligible people to continually report their work status on a government website. Critics point to Georgia as proof that work requirements are too cumbersome and reporting is too difficult. Proponents argue that the lack of participation is a revealed preference that would-be enrollees do not consider Medicaid to be worth the effort.
The Wall Street Journal recently wrote about Republicans efforts to impose work requirements in Medicaid, saying:
Policy analysts expect millions of people to lose coverage either because they won’t bother to comply with the new rules or because they aren’t able to keep up with the paperwork and other bureaucratic hurdles states will erect for proving eligibility.
The requirements, if enacted, would lead to millions of low-income people losing their health insurance or being unable to sign up in the first place, according to healthcare experts and the nonpartisan Congressional Budget Office, which advises lawmakers on the financial implications of new laws.
Conservatives say work requirements will encourage able-bodied adults to improve their lots and be more productive.
Critics of Medicaid work requirements and advocates for the poor claim that most adults receiving Medicaid are already working. Furthermore, they claim proving work is an unnecessary burden.
An estimated 18.5 million Medicaid recipients will have to start proving that they spend at least 80 hours a month working, receiving job training, attending school or performing community service, according to a CBO analysis of an earlier version of the provision passed by the House in May.
The requirements, as detailed in the Senate, would apply to adults ages 19 to 64 who are healthy and without dependent children under the age of 13 or who don’t qualify for other exemptions.
People already enrolled in Medicaid would have to prove compliance for at least one to three months twice a year. But new Medicaid applicants would have to prove that they meet the work requirements for at least one to three months before enrolling. States have the option to implement more frequent eligibility checks.
In most areas Medicaid is run by managed care organizations. That means a health plan is paid per member per month to provide service to members whether they use or value the services. Those unwilling to work, or unwilling to verify work, do not value Medicaid, but taxpayers’ money still changes hands.
The reality is that work requirements are a rationing mechanism – and there is nothing wrong with that. Everything of value must be rationed in some way. Instead of money, beneficiaries will be required to pay with a trivial amount of their time and effort. Depending on the desired result, work requirements and proving that one meets the work requirement could be made onerous or easy. In any case, work requirements will not take effect until 2027.
Are work requirements an innovative idea? It is hard to argue that able bodied adults should not have to work to receive a taxpayer-paid benefit costing thousands per year. The primary quibble is whether requiring reporting is a wasted effort, or one designed to prevent people from enrolling. In all likelihood, states and the federal government will have to experiment to find the appropriate mix of requirements that encourages work, while making it not too onerous to prove one works.
Read more at: What Medicaid Work Requirements Mean for Enrollees’ Coverage