When Medicaid was created in the mid-1960s, it was intended to provide medical care for people who truly had nowhere else to turn—namely, individuals with disabilities and the elderly. But over time, the program has ballooned, now serving 76 million people.
Even worse, nearly 40% of enrollees are now able-bodied adults. There are close to twice as many able-bodied adults in Medicaid today as there are elderly and individuals with disabilities combined.
Medicaid’s rapid growth is no secret, and it’s cause for concern across the country. Those who work with state policymakers see it firsthand—state leaders realize how consuming Medicaid has become. From Maine to Montana, the overwhelming growth of the program is often at the top of their minds.
That’s because it quite literally dictates state budgets: Medicaid gets paid first. Everything else (including education, infrastructure, and public safety) gets the scraps. Continue reading
In 2013, the Arkansas legislature voted to expand Medicaid to able-bodied, childless adults through ObamaCare. One of the primary motivations behind this decision—if not the primary factor—was the hope that expansion would save hospitals from certain demise. But after nearly six full years of expansion and hundreds of thousands of able-bodied adults added to welfare, Arkansas’ hospitals are still struggling—and many of them have closed.
This comes as no surprise to those of us who can plainly see that expanding welfare doesn’t create jobs or bolster economic activity. (Indeed, it does quite the opposite.) But still, these hospital closures simply cannot be overlooked, especially as more states consider whether or not to bring this same nightmare home.
Just this week, news reports out of Arkansas classified the health of the state’s hospitals as “condition critical.” Continue reading
Almost exactly one year ago, Arkansas became the first state to ever implement commonsense work requirements for able-bodied, working-age adults on Medicaid—and the far Left freaked out.
Since that time, they’ve proceeded to outright slander the state, falsely asserting that the requirement would leave the state worse off, hurt Arkansans, and was nothing more than a “reporting requirement” designed to confuse enrollees with paperwork rather than help them find a job. They’ve waged an all-out war on work, even using the courts to try to (temporarily) thwart the will of Arkansans, who overwhelmingly support the requirement—Republicans and Democrats alike.
They’ve gone all out for a few big reasons: they want as much dependency as possible. They think a life-long welfare check is better for Americans than a paycheck. And they also know that Medicaid work requirements are a signature achievement of President Trump’s first term.
If they can stop Arkansas, they think they can stop work requirements from spreading to other states, increase dependency, and deal a blow to President Trump at the same time. For the far Left, it’s a win-win-win.
But there’s bad news for them: from Day One, they’ve been wrong about Arkansas’ commonsense welfare reform, and a new study from the Foundation from Government Accountability proves it. Continue reading
Today, the food stamp program is one of the largest welfare programs in the federal budget. And of the nearly 40 million people enrolled, 20 million of them are able-bodied adults. This surging enrollment has led to record-high spending, topping out at nearly $80 billion just a few years ago.
The good news is that there’s a proven way to reduce dependency and improve lives at the same time: work requirements. And one state is showing once again just how effective work requirements can be, as detailed in a brand new study from the Foundation for Government Accountability (FGA).
In 2015, as one of his first major policy moves as governor, Arkansas Governor Asa Hutchinson instructed his welfare agency to let the state’s work requirement waiver expire. Under federal law, able-bodied adults without dependents are expected to work, train, or volunteer at least part-time if they want to receive food stamps. But until Governor Hutchinson took office, Arkansas had never enforced this requirement statewide.
Starting in January 2016, that changed. Able-bodied, childless adults would be expected to work part-time if they wanted to stay on food stamps. Here’s what happened. Continue reading
In June, Arkansas became the first state to ever implement a work requirement in Medicaid, after winning approval for the reform from the Trump administration in March. This speedy implementation—and pursuit of the work requirement in the first place—was, arguably, the most significant policy achievement of Arkansas Governor Asa Hutchinson’s tenure. And the implementation wasn’t just swift—it was methodical and thoughtful as well, and the Hutchinson administration has bent over backwards to make compliance as simple as possible, giving more able-bodied Arkansans a path out of the welfare trap.
Yet advocates of perpetual welfare dependency have been apoplectic, even filing a lawsuit to move Arkansas backwards. They claim that reporting work is too complex and onerous for Medicaid enrollees to possibly understand. In addition to being incredibly condescending, this claim couldn’t be further from the truth. Continue reading
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.
The state of Maine has long been on the leading edge of welfare reform. Under Governor Paul LePage, it has reformed its food-stamp program by promoting work, resulting in former enrollees’ more than doubling their incomes the following year. Maine has also worked tirelessly to find and prosecute welfare fraud, going after those who steal limited resources from the people who most need help.
These efforts, combined with Maine’s rejection of Obamacare’s Medicaid expansion, have allowed the state to make the truly needy a priority. But Maine’s not slowing down. Continue reading
The Heritage Foundation recently published their annual index on culture and opportunity. I was fortunate enough to author a chapter for them on welfare policy.
Here is an excerpt:
Unlike pre-reform recipients, individuals who enroll in the TANF program today know that their time is limited. They know, in most cases, that they are expected to work and that dependence on cash assistance is not a lifestyle they can maintain over the long term. This is good news for their well-being, because research has shown that the less time individuals spend on welfare, the quicker they will go back to work. And when they do, their incomes will more than double on average, more than offsetting lost welfare benefits and leaving them better off than they were before.
You can read the full piece here.
“We will get our people off of welfare and back to work,” President Trump said in his inaugural address. He continued that theme the next month at CPAC, the Conservative Political Action Conference. “It’s time for all Americans to get off of welfare and get back to work,” he told the crowd. “You’re going to love it, you’re going to love it, you’re going to love it.” And in his address to a joint session of Congress a few days later, the president boldly declared that “millions lifted from welfare to work is not too much to expect.”
This was music to the ears of hard-working Americans across the country, after eight long years of welfare expansion and increased dependency. But how can President Trump deliver on these promises? Continue reading
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