President Donald Trump’s administration is bound and determined to attach more work requirements to what remains of the United States’ safety net — no matter how legally questionable and ineffective, and no matter how contorted the administration’s reasoning.
A federal judge late last month appropriately invalidated the administration’s approval of Kentucky’s attempt to subject many of its Medicaid recipients to work requirements as a condition of receiving health coverage.
In approving Kentucky’s request to impose work requirements, The Trump administration never considered how many people would lose their health coverage as a result, U.S. District Court Judge James Boasberg pointed out. By Kentucky’s own estimate, 95,000 people would lose their health insurance.
And imposing a policy that directly leads to tens of thousands of low-income people losing their health coverage doesn’t help Medicaid meet its core objective, defined in federal law, which is to “mak[e] medical assistance available” to the people Congress and the states deem eligible for coverage.
In other words, work requirements don’t help people pay their medical bills. And the Trump administration made no effort to ensure that the work requirements actually advanced Medicaid’s legal purpose.
But despite clear evidence that it flouted the law in approving Kentucky’s work requirements, the administration isn’t relenting.
The Washington Post reported Wednesday that Trump’s team simply plans to re-evaluate Kentucky’s application for permission to impose work requirements, seemingly as if nothing has changed. Maine has a similar application pending with the federal Centers for Medicare and Medicaid Services.
And the White House’s Council of Economic Advisers on July 12 issued a report that attempts to justify work requirements as a condition for receiving multiple forms of public assistance, including food stamps, Medicaid and housing.
The council’s reasoning? The war on poverty declared by President Lyndon B. Johnson in the 1960s is “largely over and a success.” (Never mind that Republicans have long argued the opposite.)
The council arrives at that conclusion by using a measure of poverty based on households’ consumption, rather than the more widely accepted measures of poverty that are based on income. Of course, the council admits, the consumption-based measure is based on a threshold that’s “arbitrary,” calling into question the entire contention that poverty has actually been eliminated.
The council also argues that hunger is basically a non-issue. The U.S. Department of Agriculture concluded that nearly 13 percent of Americans experienced food insecurity in 2016. But since food insecurity isn’t always the same as reduced food intake — it indicates, at a minimum, that families don’t have consistent access to the food they require to live healthy, active lives — it apparently doesn’t rise to the level of a serious problem. Problems with hunger, the council argues, are “extremely serious…for the individuals who experience them, but they are not common.”
As the American safety net has apparently done wonders, the people being helped have become less self-sufficient, the council argues, so they need to be subject to work requirements.
Both points are the result of shoddy reasoning. Adequate safety net programs, which the U.S. doesn’t have, as evidenced by growing extreme poverty, don’t make people less likely to work. If they did, one would expect European nations with substantially more generous welfare states to have a smaller share of their populations participating in the labor force. But their participation rates are higher than the U.S.’s — another point the Council of Economic Advisers acknowledges.
Work requirements don’t magically make it more likely that the low-income people subject to them will work. Gov. Paul LePage’s administration demonstrated this reality after it cut thousands of adults off of food stamps by imposing work requirements.
The administration’s own report on the policy change found that two-thirds of those who lost food stamps still weren’t working after they lost food assistance — a number that barely changed from before they lost food stamps.
Work requirements have had an impact, though. They’ve made it more likely that thousands of Mainers are hungry — or, at least, uncertain about where their next meal might come from — as they look for work. And if work requirements take effect in Medicaid, many more people will suffer from not being able to access medical care.
The best recruits for Maine businesses surely aren’t going hungry and skipping needed medical care.
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