President Donald Trump’s administration is currently working to change the policy regarding Medicaid eligibility. Specifically, the new rules would allow individual states to introduce Medicaid work requirements in order to receive funding. However, Kansas’ welfare reform has shed some light on potential flaws with the Trump Medicaid plan.
According to the Trump administration proposal, each state would have a say regarding Medicaid eligibility for its residents, allowing them to introduce a requirement to be employed in order to receive coverage. At present, nationwide Medicaid eligibility is based primarily on the recipient’s income.
The work requirement proposal has strong Republican backing, the party having long disagreed with the Affordable Care Act (“Obamacare”) having changed Medicaid eligibility to include adults without children and who do not qualify for disability. This change qualified over 15 million additional Americans for the program.
In a telephone and online survey conducted by Rasmussen Reports, 64% of the 1,000 American adults surveyed said that healthy adult Americans without a child should be required to work in order to obtain Medicaid eligibility. Only 22% of those surveyed disagreed with the obligation of working to receive Medicaid. The remaining 14% were undecided on the matter.
Kansas Welfare Experiment Shows Potential Failure of Medicaid Work Requirements
In 2011, Kansas Governor Sam Brownback began implementing work requirements for access to forms of welfare such as food stamps and cash assistance in order to break what he called the “cycles of dependency.” While there are clear differences between Medicaid and Kansas’ welfare system, both in nature and scope, many consider the state’s experiment a small-scale example of what the Medicaid eligibility changes could look like.
Whether it’s been successful or not has been up for debate. While the amount spent on cash assistance is a third of what it was six years ago as more individuals on it have transitioned to having jobs, the decline in Kansas’ poverty rate doesn’t reflect an increase in employment, at least among people who were receiving assistance. Further, a study by the Center on Budget and Policy Priorities found that most families receiving welfare had working members both before and after Kansas’ welfare reform.
The main issues is that many of those Kansas welfare recipients require assistance for reasons that wouldn’t be addressed by an enforced work requirement. For example, those who apply for welfare may have a criminal record or have not finished high school, drastically reducing their chances of finding a well-paying job.
Work Requirements for Medicaid Recipients Can End Healthcare for Millions
Estimates show that at least 6.3 million Americans will be at risk of losing their healthcare services through the government. In the estimated numbers, approximately 10% of those impacted will be in one of the 10 “Medicaid states;” these are states with pending proposals to make Trump’s intended plan law. Almost all of these 10 states have Republican leaders, with Kentucky being the first to approve a proposed waiver. Utah, Maine, Arkansas, Indiana, and Arizona have since followed suit.
Analysis shows that 60% of adult Medicaid recipients are also working; over one-third of those unemployed are disabled or sick. Of the remaining non-workers of that total, in addition to the potential for retirees losing Medicaid (they and pregnant women are expected to be exempt, however), there would also 2.9 million caregivers losing Medicaid (specifically, caregivers providing for their loved ones) and 1.5 million students losing Medicaid.
Needless to say, Trump’s plan is a big change to the 50-year program, which acts as a safety net for Americans that cannot afford healthcare services.Only 10 states are toying with the idea for now, but time will tell if the other 40 end up enforcing a Medicaid work requirement as well.
“64% Say ‘Yes’ To Work Requirements For Medicaid Recipients,” Rasmussen Reports, January 17, 2018.
“The Trump administration’s plan for Medicaid work requirements, explained,” Vox, January 12,2018.
“Work Requirement could punish Medical recipients,” CBS News, January 29, 2018.
“Welfare Spending Drops As Fewer Kansans Receive Cash Assistance,” KCUR, May 26, 2017.
“Trump’s Medicaid Work Requirements Could Put At Least 6.3 Million Americans at Risk of Losing Health Care,” Center for American Progress, January 12, 2018.