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Advancing the Republican trope that "able-bodied" people are "gaming the system" to live in the lap of luxury on Medicaid and other subsistence benefits, the Trump administration has issued guidance to states that they can start forcing Medicaid applicants to work or prepare for jobs in order to receive coverage.
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, 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.
The new policy comes as 10 states are already lined up, waiting for federal permission to impose work requirements on able-bodied adults in the program. Three other states are contemplating them. Health officials could approve the first waiver—probably for Kentucky—as soon as Friday, according to two people with knowledge of the process.
Here's the reality:
So this applies to maybe 9 percent of the Medicaid population.
That 9 percent could be people who just lost their jobs, who have mental illness, or cancer, or—more and more frequently—substance abuse disorders. In fact, 36 percent of people who are on Medicaid and don't qualify for Social Security disability are not working because of a health issue.
They are people falling through the gaping holes torn in our safety net. They are people who already work minimum wage jobs and might qualify for Medicaid expansion in the states that implemented it. What it will do is prevent people who are eligible and in need of coverage from getting it, because the hoops will be too numerous and/or difficult to jump through.
Work requirements don't work to do what Republicans insist they do: create working, independent lives for people. We know this from welfare reform efforts in previous decades. We wouldn't be having this conversation now if that had worked.
This is nothing more than more punishment for poor people. Period.