Defunding Medicaid

How do you cut Medicaid funds without cutting Medicaid funds? Congressman Lawler is slipping in the defunding back door to answer that question. He continues to promote —in the media and in Sunday evening’s town hall—instituting work requirements for people on Medicaid. This will put 36 million people at risk for losing health insurance coverage, but Republicans estimate decreased enrollment will also save $120 billion from Medicaid.

Even so, Congressman Lawler must know work requirements are counter to Medicaid’s main objective—to provide health coverage to people with low income.

Adding work requirements is morally unacceptable because it risks participants losing coverage. People’s health is negatively impacted when they delay seeing a doctor for chronic or new conditions and when they skip taking medications which they can’t afford.

A large majority of adult Medicaid beneficiaries who can work already do. In 2023 an analysis found that 71 percent of Medicaid recipients were either in school or working full or part time. An additional 12 percent were caregivers, and some part-time workers were also enrolled in school or work training programs.

Employed adults who rely on Medicaid frequently work in low-wage positions with variable hours, such as service or retail jobs, which often do not offer employer-sponsored insurance or affordable coverage. These jobs can prevent them from consistently meeting monthly requirements. Low-income people are also likely to experience other barriers to employment requirements, such as limited access to transportation, lack of internet access, caregiving responsibilities, and chronic health problems — any of which can make finding or keeping a job challenging.

Work requirements place significant reporting barriers on Medicaid enrollees. Reporting work hours can be especially difficult for people multiple jobs, caregiving responsibilities, people without internet or computer access, and people with limited English proficiency.

On example is in Arkansas, where more than 18,000 Medicaid enrollees lost coverage in the nine-month period in which the work requirement was in effect. A major cause was many Medicaid enrollees, who were subject to the work requirements, found the reporting process “confusing” or “inaccessible”, and nearly a third of the target population was unaware of the policy altogether. Thankfully, the federal government stepped in to stop the work requirement.

Congressman Lawler values the savings resulting from work requirements, but apparently he doesn’t care about saddling people with red tape and one-size-fits-all requirements.

Who would want work requirements for Medicaid? Those who don’t believe healthcare is a human right.