Work Requirements for Medicaid Will Only Make Poverty Worse

man completing work requirement in factory

Last month, President Trump allowed states to move ahead with their plans to impose work requirements on Medicaid recipients. Kentucky quickly implemented their plan, and South Dakota, Alabama, Louisiana and South Carolina appear poised to do set up requirements of their own in the coming weeks. But studies have shown that work requirements will not help people rise out of poverty, and may even make matters worse for the most vulnerable among us.

The Republican position on welfare programs, such as Medicaid, Temporary Assistance for Needy Families (TANF), and Food Stamps, has long been that they trap people in poverty and hold them back from securing work. The GOP sees it as their civic duty to free people from this trap by putting in place restrictions to welfare access.

But this idea has been tried before, and it’s not effective in the long run. In fact, it just makes life harder for people in poverty.  

In 1996, a work requirement was added to TANF with decent short-term outcomes (enrollment in TANF dropped and employment increased in the first two years). But after five years, data showed that the work requirement was making little to no difference in keeping people in stable and lucrative work. The only jobs that TANF recipients could find were jobs which paid poverty wages. And general instability in their lives, including lack of child care, illness, and addiction made it difficult for welfare recipients to maintain the jobs over time.

What’s more, the idea of making work a prerequisite to getting healthcare is obviously backward. People who are in good health are more capable of finding and keeping work than those who struggle with chronic pain, mental illness, or addiction. To deny people healthcare if they are not able to work is to render more of the potential workforce incapacitated and vulnerable.

And then there is the matter of work requirements interfering with unpaid caregiving work. TANF required that individuals work anywhere from 20-30 hours per week and for people with young or disabled children and elderly parents, being pulled away from these dependents creates more problems than it solves.

Republican notions of welfare dependency show a blatant disregard for scientific studies and reflections on past lessons. Anti-poverty programs, and especially those that mandate work, have not been proven effective. It is for this reason that many on the left have begun considering the alternative of universal basic income, or money given out freely to citizens with no strings attached. Anathema as this idea is to the judgemental conservative outlook on welfare, it may be much more likely to succeed than anything that has been tried so far. But, with Republicans in power, we are likely to continue bullishly repeating mistakes of the past, hoping in vain for different outcomes.