The Ohio Medicaid expansion covers approximately 700,000 people. Kentucky was approved for a work requirement waiver by the Centers for Medicare and Medicaid Services in January 2018. Nine other states have applied for waivers.
A federal judge ruled Kentucky’s work requirements unconstitutional on June 29, meaning the courts will have to decide their constitutionality.
The Affordable Care Act, enacted in 2010 by congressional Democrats and the Obama administration with no Republican votes in favor, allows states to expand Medicaid to include able-bodied adults. The number of people enrolled in Medicaid has greatly expanded in the states that accepted the deal, and the Trump administration implemented new rules to open the door for states to implement work requirements.
Calls Requirements Beneficial
The Medicaid work requirements states have proposed thus far typically require able-bodied adults to work for a specified number of hours each month, enroll in a qualifying job-training program or other education option, or perform some other designated service to the community. Those expectations are beneficial for people who are physically able to work, says Justin Haskins, a research fellow at The Heartland Institute, which publishes Health Care News.
“Anyone who is unwilling to fulfill these basic requirements shouldn’t be allowed to continue receiving free Medicaid coverage,” Haskins said. “Allowing people to forever remain enrolled in Medicaid keeps entire families trapped in government dependency, which is particularly troubling given that numerous studies show Medicaid is an inferior form of health coverage.
“Work requirements help ensure only those who truly need Medicaid receive it, saving taxpayer money and shoring up Medicaid’s long-term viability,” Haskins said.
Haskins says opponents of work requirements are wrong to say they are unnecessary and are designed to punish poor people.
“Nothing could be further from the truth,” Haskins said. “Work requirements incentivize people to get the job training and work experience they need to move out of poverty, and they help ensure Medicaid, an extremely costly program, remains in place for years to come. That’s incredibly important, because lots of disabled Americans and children depend on Medicaid for their health care, and they aren’t able to work and receive private health insurance in the market the way able-bodied people can.”
Expects Increasing Popularity
Matt Glans, a senior policy analyst at The Heartland Institute, says work requirements could become a popular policy.
“Assuming the courts permit work requirements to exist, it’s likely many states will eventually create Medicaid work requirements,” Glans said. “Not only do they encourage work and self-sufficiency, they also improve state budgets, keep tax rates lower, and protect Medicaid for America’s most vulnerable citizens.
“Without work requirements, there is often nothing to encourage people who could work to do so,” Glans said. “And even when people do work, they are often encouraged not to earn more money, because if they do, they risk losing their Medicaid benefits.”
Travis Akin ([email protected]) writes from Chicago, Illinois.