www.washingtonpost.com
Open in
urlscan Pro
104.78.189.162
Public Scan
URL:
https://www.washingtonpost.com/opinions/2023/04/27/medicaid-work-requirements-healthcare/
Submission: On May 02 via manual from US — Scanned from US
Submission: On May 02 via manual from US — Scanned from US
Form analysis 1 forms found in the DOM
<form class="w-100 " autocomplete="off">
<div class="relative flex"><input class="pl-sm pr-sm font--subhead font-xxs h-md light brad-2 b form-input-valid bg-white gray-darkest flex-grow-1 w-50-ns ma-0 border-box" id="paywall__input-field" type="email" autocomplete="email"
data-private="true" value="" style="transition: padding 200ms linear 200ms; border-top-right-radius: 0px; border-bottom-right-radius: 0px;"><label for="paywall__input-field" class="absolute"
style="transition: all 200ms ease-in-out 0s; transform: translate3d(16px, -50%, 0px); transform-origin: left top; top: 50%; color: rgb(90, 90, 90); pointer-events: none;">Enter email address</label></div>
<div class="dn">
<div class="db mt-xs mb-xs ease-in-out duration-400 left mt-xs"><label for="tosCheckbox" class="db gray-dark relative flex pt-xxs pb-xxs items-start "><span class="relative mr-xs" style="height: 16px; width: 16px;"><input id="tosCheckbox"
class="tos-checkbox b bc-gray-light bg-white brad-2 relative outline-none appearance-none ma-0 " type="checkbox" data-testid="tosCheckbox" style="height: 16px; width: 16px;"><svg class="absolute top-50 left-0 -translate-y-50 dn"
viewBox="0 0 24 24" xmlns="http://www.w3.org/2000/svg" style="height: 16px; width: 16px;">
<title>Check</title>
<path d="M10.052 16.245L3.265 9.46l-1.767 1.768 7.778 7.778a1.25 1.25 0 0 0 1.863-.107L23.415 3.413 21.456 1.86 10.052 16.245z" fill="#fff" fill-rule="nonzero"></path>
</svg></span><span class="db font-xxxxs" style="padding-top: 1px;"><span data-testid="tosCheckboxText">By signing up, you agree to the
<a target="_blank" style="color:inherit;" class="underline" href="https://www.washingtonpost.com/terms-of-service/2011/11/18/gIQAldiYiN_story.html">Terms of Service</a> and
<a target="_blank" style="color:inherit;" class="underline" href="https://www.washingtonpost.com/privacy-policy/2011/11/18/gIQASIiaiN_story.html">Privacy Policy</a>.</span><span class="font-xxs red"
style="line-height: 0;">*</span></span></label></div>
</div><button id="CTA_BUTTON_TEXT_CTA_WRAPPER" role="button" class="btn db dib-ns mt-sm ma-0 pointer dib btn subs-theme bg-blue" type="submit"
style="white-space: normal; box-sizing: border-box; border-radius: 31px; padding: 7px 32px; width: 100%; border: initial;"><span id="CTA_BUTTON_TEXT" data-public="true">Start reading</span></button>
</form>Text Content
Accessibility statementSkip to main content Democracy Dies in Darkness Subscribe Sign in Close The Washington PostDemocracy Dies in Darkness OpinionsEditorials Columns Guest opinions Cartoons Submit a guest opinion Today's Opinions newsletter OpinionsEditorials Columns Guest opinions Cartoons Submit a guest opinion Today's Opinions newsletter OPINION HOW THE GOP’S MEDICAID WORK REQUIREMENTS WILL BACKFIRE By Catherine Rampell Columnist|AddFollow April 27, 2023 at 6:15 p.m. EDT The U.S. Capitol on April 19. (J. Scott Applewhite/AP) Listen 4 min Comment on this storyComment853 Gift Article Share Unlike most things in the House Republicans’ debt-limit bill — such as those across-the-board spending cuts — there is one measure that might secure widespread support: adding work requirements to Medicaid. In past surveys, even a significant share of Democratic voters appeared amenable to the idea. WpGet the full experience.Choose your planArrowRight But Medicaid work requirements are a solution in search of a problem. Worse than that, they will create significant new problems, particularly among the vulnerable population the policy is supposed to help. The perception that Medicaid is saturated with lazy shirkers is false. About 60 percent of nonelderly adults on Medicaid are already working, according to the Kaiser Family Foundation. Most of those not working either have a disability or serious medical condition or caregiving responsibilities, or they are enrolled in school — all of which happen to be among the specific exemptions laid out in the GOP bill. Advertisement Story continues below advertisement If most Medicaid recipients are working anyway, or are exempt from the requirements, you might ask what’s the harm in asking them to provide evidence of their compliance? Perhaps in the process, you might also nudge some of those not working into gainful employment. Follow Catherine Rampell's opinionsFollow In theory, this sounds reasonable. In practice, implementation can be a Kafkaesque nightmare. We know this because it was tried in Arkansas in 2018, with backing from the Trump administration. By the time a federal judge paused Arkansas’ experiment less than a year after it launched, 18,000 lower-income people had already been purged from the state Medicaid rolls — and not necessarily because they were failing to work 80 hours a month, as the state required (and as the new House GOP bill would mandate, too). Many were working but found it challenging to prove to the state that they met the “community engagement” requirements or allowable exemptions. That’s because the reporting process was confusing and onerous. Advertisement Story continues below advertisement In fact, at least one person I interviewed at the time had been working, but was forced out of his work as a result of the reporting requirements. Adrian McGonigal, a full-time employee at a poultry plant, had difficulty accessing the state website required to log his hours. He was abruptly disenrolled from Medicaid and was unable to afford the medications he needed to manage his severe COPD, a chronic lung disease that makes it difficult to breathe. McGonigal landed in the emergency room multiple times, missed too much work and ultimately lost his job. In other words, for people such as McGonigal, access to health insurance and care should be seen as a work support, rather than a work disincentive. Story continues below advertisement A subsequent analysis of the Arkansas program, published in Health Affairs, found that it did not increase employment levels. But it did have long-term, adverse consequences for those who lost coverage. Of those purged, 50 percent reported serious problems paying off medical debt, 56 percent delayed care due to cost, and 64 percent delayed taking medications because of cost. Advertisement How much can we generalize from Arkansas’ experience? Its program did seem to be particularly poorly executed, after all. The state’s Medicaid enrollees were required to use a glitchy web portal, which perplexingly shut down every night from 9 p.m. to 7 a.m. (for “scheduled maintenance,” I was told). The site also didn’t work well on smartphones. Many lower-income Arkansans, McGonigal included, don’t otherwise have reliable access to the internet. Theoretically, maybe Congress could design a version of this policy that would be less likely to harm “deserving” Medicaid enrollees. This would require a much bigger, more robust and more expensive bureaucracy, so that the state correctly identifies and penalizes only the tiny minority of Medicaid recipients not already working or with valid exemptions from work. Story continues below advertisement The cost of such a system might not outweigh whatever savings are achieved by purging those few “undeserving” loafers. Advertisement And again: to what end? Helping more people find work, and move up the income ladder, is a worthy goal. But there’s little evidence that this particular policy would achieve that. It didn’t in Arkansas, and the Congressional Budget Office expects that the version included in the House bill wouldn’t, either. In a letter on Wednesday, the CBO concluded the measure “would have a negligible effect on employment status or hours worked by people who would be subject to the work requirements.” On the other hand, the policy would result in roughly 1.5 million Americans nationwide losing federal funding for their Medicaid coverage, the CBO estimated. States would then have to decide whether to cut these enrollees loose or find and fund alternative means of coverage. By all means, let’s help more Americans find jobs. Having bountiful job openings helps. Education, training and other government programs specifically designed to encourage work are all important, too. So is keeping the populace healthy enough to work. 853 Comments GiftOutline Gift Article Popular opinions articles HAND CURATED * Opinion|E. Jean Carroll might deliver the first significant hit to Trump April 30, 2023 Opinion|E. Jean Carroll might deliver the first significant hit to Trump April 30, 2023 * Opinion|Democrats begin to target vulnerable GOP seats April 27, 2023 Opinion|Democrats begin to target vulnerable GOP seats April 27, 2023 * Opinion|My death is close at hand. But I do not think of myself as dying. April 27, 2023 Opinion|My death is close at hand. But I do not think of myself as dying. April 27, 2023 View 3 more stories Subscribe to comment and get the full experience. Choose your plan → View more Loading... Advertisement TOP STORIES Technology Big Tech news and how to take control of your data and devices How Mark Zuckerberg broke Meta’s workforce Elon Musk describes Starship flight as ‘roughly what I expected’ Twitter founder Jack Dorsey says Musk wasn’t an ideal leader after all Refresh Try a different topic Sign in or create a free account to save your preferences Advertisement Advertisement Company * About The Post * Newsroom Policies & Standards * Diversity and Inclusion * Careers * Media & Community Relations * WP Creative Group * Accessibility Statement Get The Post * * Become a Subscriber * Gift Subscriptions * Mobile & Apps * Newsletters & Alerts * Washington Post Live * Reprints & Permissions * Post Store * Books & E-Books * Newspaper in Education * Print Archives (Subscribers Only) * Today’s Paper * Public Notices Contact Us * Contact the Newsroom * Contact Customer Care * Contact the Opinions team * Advertise * Licensing & Syndication * Request a Correction * Send a News Tip * Report a Vulnerability Terms of Use * Digital Products Terms of Sale * Print Products Terms of Sale * Terms of Service * Privacy Policy * Cookie Settings * Submissions & Discussion Policy * RSS Terms of Service * Ad Choices washingtonpost.com © 1996-2023 The Washington Post * washingtonpost.com * © 1996-2023 The Washington Post * About The Post * Contact the Newsroom * Contact Customer Care * Request a Correction * Send a News Tip * Report a Vulnerability * Download the Washington Post App * Policies & Standards * Terms of Service * Privacy Policy * Cookie Settings * Print Products Terms of Sale * Digital Products Terms of Sale * Submissions & Discussion Policy * RSS Terms of Service * Ad Choices 4.14.30 Already have an account? Sign in -------------------------------------------------------------------------------- TWO WAYS TO READ THIS ARTICLE: Create an account Free * Access this article Enter email address CheckBy signing up, you agree to the Terms of Service and Privacy Policy.* Start reading Subscribe $4every 4 weeks * Unlimited access to all articles * Save stories to read later Subscribe