Allowing Medicaid Work Requirements Will Harm Most Vulnerable Americans

By Consumers for Quality Care, on January 18, 2018

Photo by Heidi de Marco/KHN

The Trump administration announced it would allow states to implement work requirements for Medicaid recipients, the Washington Post reports. The change signifies a fundamental shift in the program’s policy.

At the time of the announcement, 10 states had already requested federal permission to add work requirements to their Medicaid programs and Alabama, Idaho and South Dakota are considering doing the same.

The letter to state Medicaid directors opens the door for states to cut off Medicaid benefits to Americans unless they have a job, are in school, are a caregiver or volunteer, or participate in other approved forms of “community engagement” — an idea that some states had broached over the past several years but that the Obama administration had consistently rebuffed.

Many health policy experts, including some conservatives, have argued that affordable medical care should not be contingent on other circumstances and that the change will have a negative impact on the millions of poorest Americans who depend on Medicaid to afford medical care.

Leonardo Cuello, health policy director at the National Health Law Program, criticized the federal government for not allowing public comment on this new rule and rebuffed the administration’s argument that work leads to good health:

Cuello said the argument that work promotes health is “totally contorted . . . It’s a little like saying that rain causes clouds. It’s more that people [with Medicaid] get care, which helps them be healthy and makes them able to work.”

Data shows the majority of non-elderly adults already work and those who do not are ill, disabled, caregivers or students.  Compliance with these new reporting rules could pose hardships for those individuals, as well as those with fluctuating incomes and employment, and put their health benefits at risk.

Eliot Fishman, senior health policy director at Families USA called the rule change “unconscionable and illegal,” pointing out that the new policy would accomplish the opposite of its intent:

Today’s announcement isn’t about work. It is about taking away health insurance from low-income people.

Critics of the administration’s new policy have said they will challenge its legality in court.