Pennsylvania Considers Work Requirements for Medicaid

Published June 19, 2018

The General Assembly of Pennsylvania is considering adding work requirements to Medicaid as part of legislation intended to scale back the cost and size of entitlement programs and encourage work and self-reliance.

Originally intended to provide health care for poor families and the severely disabled, Medicaid has become the nation’s largest health insurance program.

Encouraging Self-Sufficiency

Matthew Glans, a senior policy analyst at The Heartland Institute, which publishes Health Care News, says workfare reforms help able-bodied people become self-sufficient.

“Work requirements will bring greater cost certainty to Pennsylvania’s welfare programs while helping to move people through the program and out of poverty,” Glans said. “States that have enacted work requirements have enjoyed significant success. In Maine, able-bodied adult recipients without dependent children are required to work, participate in a work program for 20 hours per week, or do community service for about six hours per week to receive benefits.”

Waivering Commitments

Pennsylvania state Rep. Mike Tobash (R–Schuylkill Haven), author of the legislation, says work requirements have proven successful since they were first implemented in the 1990s. The Obama administration took a far different approach from its predecessors, routinely issuing waivers for states to opt out of work requirements for entitlement programs. Tobash says the waivers were never necessary because work requirements are nothing new.

“It’s consistent with the federal guidelines to have work requirements,” Tobash said. “In 1996, President Clinton signed into law the Personal Responsibility and Workforce Opportunities Act, which included work requirements for these programs. Unemployment rates in 1996 were low, and they’re lower now. But when unemployment rates ticked up, President Obama offered blanket waivers to states, and many states took advantage of them and waived the work requirements.”

The Trump administration ended the Obama state waiver program and gave cities and counties the option of applying for waivers locally.

“When the waivers were later disallowed, states were given the option of applying for waivers for individual counties and cities,” Tobash said. “In Pennsylvania, which has 67 counties, 59 counties have been waived, along with 10 cities, all at a time when unemployment rates have been going down.”

‘Good for the Family’

Given the current low national unemployment rate—the lowest in 18 years—there is no reason to continue exempting able-bodied people from work requirements in entitlement programs, Tobash says.

“The bill I introduced simply says that if you are able-bodied and you do not have dependents that you need to take care of, we should not be waiving these requirements unless we really take a look at the waived counties and see that there’s a real, compelling reason to waive them,” Tobash said. “So we’re asking, through this piece of legislation, for able-bodied people to work, volunteer, or to be in a training program in order to receive the benefits. We’re not talking about the elderly; we’re not talking about disabled veterans, or people who are taking care of young children or indigent adults. We’re simply asking Pennsylvania to go back to a requirement that made sense in 1996 when unemployment rates were low; to go back to that standard.

“Ronald Reagan said that the best social program is a job,” Tobash said. “There is dignity that is found in work. It’s good for the family, and it’s good for the community.”

Reforms vs. Tax Hikes

Unless states implement these reforms, entitlement programs will continue to grow at unsustainable rates while perpetuating the cycle of poverty, Glans says.

“Without work requirements, Medicaid and other entitlement programs will continue to grow at a rate that will one day be unsustainable without substantial tax increases,” Glans said. “The real focus of welfare programs must be to provide temporary or supplemental assistance while encouraging work and independence. States should also reform assistance programs that trap low-income Americans in poverty by disincentivizing work.

“Work requirements, workfare programs, and education efforts will not solve the problem of poverty, but they will ensure those who can work will be given the chance and motivation to do so,” Glans said.

Internet Info:

“Research & Commentary: Pennsylvania Considers Adding Work Requirements to Medicaid and SNAP,” The Heartland Institute, April 19, 2018:–commentary-pennsylvania-considers-adding-work-requirements-to-medicaid-and-snap

“Trump Administration Reverses Little-Used Welfare Waivers,” U.S. News & World Report, August 30, 2017: