It’s generally wise to steer clear of anyone claiming to be working on behalf of someone else’s “dignity and self-respect.”
That’s the guise under which Trump administration officials and lawmakers are pushing for the ability to impose work requirements on the poor in exchange for their ability to get health care through Medicaid.
Those lawmakers include both Congress and Harrisburg — both of whom have excellent health coverage despite the fact they have been unable to produce much in the way of work themselves for some time.
State lawmakers last summer passed a bill that would impose work requirements on those receiving Medicaid, the last-resort medical coverage for low income people; the bill was vetoed by Gov. Wolf. Recently, the Trump administration announced it was open to states’ being able to impose those requirements by granting waivers to the law. This is a reversal of decades of policy that prohibited such restrictions.
States would be able to cut off Medicaid benefits to people unless they have a job, are in school, are caregivers or volunteers, or participate in community engagement. Ten states have already applied for waivers that would allow them to impose requirements; Kentucky has been granted such a waiver.
Work requirements are already in place for food stamps and welfare — and Harrisburg lawmakers have recently moved to increase those requirements for those receiving food stamps, through House Bill 1659. The bill would prohibit easing work requirements in areas where jobs are scarce. But imposing work requirements in exchange for the ability to get medical treatment is not only inhumane, but would save little, if anything, especially considering the administrative structure that would be required to monitor Medicaid recipients job-seeking efforts.
Those in favor of this cruelty claim people with jobs and good benefits are healthier, so encouraging work will benefit people’s health. That’s a nice fantasy against the reality of low-wage jobs that are inadequate to raise a family or afford health coverage. It’s also underscores the lack of understanding of Medicaid.
According to the Kaiser Family Foundation, nearly 80 percent of Medicaid recipients live in working families; nearly 60 percent are working themselves, figures consistent with Pennsylvania’s numbers. Most of those who don’t work have impediments like disabilities or care-giving responsibilities. As we have seen in a recent Inquirer report, getting SSI disability can be a daunting challenge, and many disabilities and illnesses don’t rise to the level of SSI. Unfortunately, that includes opioid addiction, so cutting off Medicaid to those needing treatment will only exacerbate the current crisis.
It’s true that Medicaid represents a huge financial commitment. So do tax cuts for the wealthy, and giveaways to corporations. The underpinning of these supposed cost-saving Medicaid measures is a favorite myth of Republicans: that the poor are content to live off the government and that given the choice between working and not, they’d rather not.
If people’s dignity and self-respect is really a goal, there are simple ways to achieve that: Stop demonizing them and take actions like raising the minimum wage, that would allow people to support themselves and their families, and maybe afford health care.