Medicaid work requirements are one of these things Republicans trot out to demonize low-income people as lazy mooches—in total defiance of reality. As of 2019, according to KFF, 63% of adult Medicaid recipients who weren’t elderly, on SSI, or dually eligible for Medicaid and Medicare were working. Of those, 48% were working full-time. Caregiving responsibilities (12%), being in school (7%), and disability or illness (10%) were among the reasons people gave for not working. The Center on Budget and Policy Priorities found in 2018 that 79% of Medicaid recipients were in households where at least one person was working.
Republican efforts to impose work requirements, in other words, are, on the surface, largely aimed at people who have extremely good reasons for not working and who are a small proportion of Medicaid recipients anyway. But they wouldn’t just affect those people who are not working, because the work requirement would add paperwork and extra hurdles even for people who are working to prove that they are and keep their Medicaid. Similarly, while work requirements often exempt at least some people with disabilities, those reporting requirements may be barriers as well, so that disabled people who should remain eligible for Medicaid get kicked out of the program.
It’s not about any of that for Republicans, though. It is, as always, about the cruelty. It’s about conveying to the public that Medicaid recipients aren’t working, and that they could and should, and then would stop needing government assistance. (In reality, of course, lots of jobs don’t offer health coverage and pay so little that people remain eligible for Medicaid. And Republicans do not want to change that side of the equation, either, by raising the minimum wage or improving health care access.)
Reams of available facts contradict every Republican argument for work requirements. But none of that will stop Republicans like Rep. Byron Donalds from saying things like, “If you're able-bodied and you can gain employment, why are you on Medicaid unless that was just a pure poverty situation?” That’s a big “unless,” my dude! Are you aware of the relationship between the minimum wage and a living wage? Because in your home state of Florida, the minimum wage is $11 an hour—a heckuva lot better than the federal level of $7.25, but still well short of the $17.72 that counts as a living wage for a single adult with no children in Florida.
The latest Republican push to make Medicaid more punitive comes after voters in some pretty red states have approved Medicaid expansion under the Affordable Care Act. South Dakota voters approved a ballot measure in November 2022, just the latest in a string of such votes. But it’s possible that the work requirements message will work with Republican voters—after all, most of the people they know who get Medicaid are already either working or have very good reason not to be. The Republican mindset allows people to believe that while that’s true of the people they know, somewhere out there a different type of person is just mooching. And by the time they realize that work requirements will create problems for their friends and family, too, the damage is done.
If Gaetz is proposing this as part of a debt ceiling fight, though, Democrats shouldn’t even need to actively engage on the specific plan, because the answer to Republican hostage-taking on the debt ceiling has to be a flat no, or maybe hell, no.
McCarthy says he’s taking the economy hostage ‘for the American people’
Matt Gaetz talks ‘entitlements,’ suggests work requirements for SNAP and Medicaid recipients
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