health care reform

The Hill: Work requirement essential to health care reform

/ Nic Horton / Leave a comment

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 →

Platte Institute: Arkansas Not a Model for Nebraska

/ Nic Horton / Leave a comment

A new paper by Jonathan Ingram and Nic Horton examine the impact an Arkansas-style Medicaid expansion would have on Nebraska:

Nebraska legislators have taken a thoughtful approach to the Affordable Care Act, carefully reviewing the evidence and ultimately declining to expand Medicaid to a new class of able-bodied adults under the law. Nevertheless, a small group of legislators lobby their colleagues each year to expand the program. The latest proposal, offered by Senator John McCollister, would copy the expansion models used by Arkansas and Iowa, homes of the highest profile “alternative” expansion models.

Under this approach, able-bodied adults receive regular Medicaid benefits through private health insurance plans sold on the Exchange, rather than through traditional Medicaid managed care. But these expansions have been unmitigated disasters and replicating the results in Nebraska would move the state backwards.

This new approach to Medicaid expansion is unaffordable and unpredictable, pushes adults out of private insurance and into taxpayer-funded welfare, puts the truly needy on the chopping block, discourages work, and shrinks the economy. So it should be no surprise that, last year, Iowa policymakers scrapped the model entirely and Arkansas enacted legislation to repeal the expansion altogether at the end of 2016. Nebraska policymakers should learn from these mistakes, not repeat them.

Read the full paper here.