Medicaid is out of control and unsustainable. Work requirements could help.
It’s not the lead story on the nightly news, and it’s not generating millions of clicks online. It may be one of the most underreported, underappreciated public-policy crises of our time. That’s a terrifying reality because, left unaddressed, this crisis will come at great cost to America’s most vulnerable.
The Medicaid program is at its breaking point. Even before Obamacare lured some states into expanding the program to non-disabled, working-age adults, Medicaid was growing at an alarming rate. Now, in the Obamacare era, the program is growing even faster, siphoning more and more resources away from folks who truly depend on Medicaid for survival.
A new report, released this week by the Foundation for Government Accountability, gives a glimpse of just how serious the problem is.
Late Monday, House GOP leaders released several changes to the American Health Care Act, the House’s vehicle for partially repealing and replacing ObamaCare. The amendment would eliminate enhanced funding for new Medicaid expansion states and reducing funding for new enrollees in existing expansion states, starting in 2020. These are both critical steps to protect limited dollars for the truly needy and music to the ears of conservatives who have rightfully raised concerns that the AHCA would not roll back ObamaCare’s failed Medicaid expansion.
But the amendment doesn’t stop there. It would also allow states to create TANF-style work requirements for most non-elderly able-bodied adults on Medicaid (pregnant women, parents with children under six years old, and 20 year olds in school would be exempted in states that chose to accept the work requirements). And while a food stamp-like work requirement is preferable, this is certainly a step in the right direction.
Work requirements are an essential part of any replacement plan that comes out of D.C. Without work requirements in place, individuals have no incentive to increase their incomes or leave dependency. They actually face a massive disincentive to do just that. Continue reading
Last week, with little fanfare, the U.S. Senate passed a bill to begin dismantling Obamacare. Some pundits have spun the move as little more than “political posturing” or a toothless act that simply fulfills the campaign promises of a newly elected GOP majority. The truth is that this Senate vote is much bigger than Obamacare supporters would like you to believe. In fact, the Senate vote has literally changed the Obamacare debate forever.
The Senate bill repealed the employer and individual mandates, repealed the Cadillac and medical device taxes, eliminated exchange subsidies, and removed the federal government’s authority to run the Obamacare exchanges. All good things.
But what may be the most significant—and least discussed—change is sure to send shockwaves through all 50 state capitals: the U.S. Senate voted to repeal Obamacare’s Medicaid expansion entirely.
To paraphrase Vice President Joe Biden, “This is a big freaking deal.” Continue reading