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.
Arkansas made national headlines in 2013 when then-governor Mike Beebe, a Democrat, struck a deal to make Arkansas the first southern state to expand Medicaid through Obamacare. Shortly thereafter, Beebe exited (stage left), leaving a fiscal, political, and moral disaster for the new administration to grapple with. But now, thanks in large part to the leadership of Republican governor Asa Hutchinson, Arkansas is taking significant steps toward reversing Obamacare’s devastating impact. Other expansion states should take note. Continue reading
Policymakers in the Land of Lincoln have some important work to do this year to preserve limited state resources for the truly vulnerable. Stopping the enrollment of able-bodied adults in Illinois’ Medicaid expansion program, and instituting work requirements for able-bodied adults in Medicaid are necessary to safeguard the program for Illinoisans most in need of services.
A Medicaid enrollment freeze waiver can preserve resources for truly needy Illinoisans
To stop Medicaid expansion enrollment, Illinois policymakers should ask the Trump administration for an enrollment freeze waiver. The program is devouring state tax dollars that could go to help Illinois’ truly needy residents, including the 18,000-plus Illinoisans on Medicaid’s Prioritization for Urgency of Need for Services waiting list. An enrollment freeze waiver would allow state officials to stop the hemorrhaging of Medicaid dollars and begin to immediately prioritize truly vulnerable Illinoisans once again.
Medicaid work requirements can prevent the safety net from becoming a poverty trap
But that’s just the beginning of what Illinois officials must do to reform the state’s overgrown and unsustainable Medicaid system. The state should also request a waiver to institute work requirements for all able-bodied adults in Medicaid. Medicaid’s safety net has become a web that traps too many Illinoisans in dependency. But with the requirements in place, the truly vulnerable and taxpayers will find much-needed relief. Equally important, enrollees will be better able to transition to self-sufficiency.
Currently, Illinois’ Medicaid program is operating as a welfare trap – a system that encourages individuals to remain in dependency indefinitely and penalizes them if they try to leave. There’s perhaps no better proof of this phenomenon than the number of Illinoisans who are in the Medicaid program and not working at all.
According to the most recent data from the U.S. Census Bureau, less than one-third of all able-bodied, working-age Medicaid enrollees in Illinois work full time. By contrast, nearly 36 percent don’t work at all.
In addition, according to data from the Department of Healthcare and Family Services, nearly 54 percent of able-bodied adult enrollees in the Medicaid expansion reported no income at all in 2015. Continue reading
Illinois’ Medicaid program has spiraled out of control. Since opting to expand Medicaid through Obamacare, the state has enrolled roughly 650,000 able-bodied adults – nearly twice as many as the state said would ever even qualify, much less enroll. Over that same period, 752 truly needy Illinoisans have died on a waiting list for medical treatment. And with a large Obamacare bill due in less than a month, policymakers should start working now to put the brakes on this nightmare.
Thankfully, simple, tested and effective policy solutions exist to the challenges facing the state. By freezing enrollment in its Medicaid expansion program, Illinois can immediately begin protecting resources for its truly vulnerable citizens and help Illinoisans currently trapped in welfare get back on the path to independence. In addition, lawmakers would immediately provide much-needed relief to overburdened state taxpayers.
Enrollment freezes are simple: Rather than pulling the plug on the expansion program overnight, the state would allow current enrollees to stay for the time being, but would stop enrolling new members. This allows lawmakers to gradually wind down the program over time, but immediately free up resources for the truly vulnerable.