(Quin Hillyer, Liberty Headlines) Work worked for welfare, so why not make work work for Medicaid as well?
That idea – requiring federal aid recipients to do some sort of work in return – is animating a new bill by U.S. Rep. Morgan Griffith, a fourth-term Republican from Virginia. It is expected to prove highly controversial, even though a similar idea was a successful linchpin for the landmark welfare reform legislation of 1996 – which cut welfare rolls by more than half while (arguably) helping push the poverty rate down.
Griffith’s Medicaid Individual Responsibility Bill, introduced on Thursday, would allow (but not compel) states to implement work requirements for able-bodied Medicaid recipients. (The disabled, pregnant, and elderly, among others, would be exempt.) The states would have leeway to design the exact nature of those work requirements.
“Medicaid is a safety net for those who need help, but it was never intended to be a long term benefit for abled bodied adults who choose not to work,” said Griffith in a press release. “For those that can’t find jobs, training programs, education, and job search assistance can be provided to help them meet the work requirement. This will allow recipients to move into a situation where they can better support themselves and their family so they no longer need the safety net of Medicaid.”
Most conservatives say a requirement for work, training or education was the single most important component of the welfare reform called The Personal Responsibility and Work Opportunity Reconciliation Act of 1996. It is indisputable that welfare rolls dropped fairly quickly by about 50 percent, and eventually by 75 percent, after that reform. It is also indisputable that poverty rates, including child poverty, declined after passage of that law – although conservatives and liberals still argue bitterly about whether the law helped or somehow actually hampered that beneficial decline in the poverty rate.
Critics from the political Left long have disputed the 1996 law’s success, with one student even producing a 2015 Duke University Law Journal report called “Punishing the Poor Through Welfare Reform.” And senior economics writer Jordan Weissman for the liberal Slate online journal said the reform made welfare “a zombie system rather than the bridge from poverty to work that its reformers envisioned.”
Countering this, even Ron Haskins of the left-center Brookings Institution concluded that the 1996 reform “played a major role in increasing the work rate among mothers and substantially reducing the poverty among mothers and children in single-parent families.”
Several states in recent years have petitioned the federal government for the flexibility to apply similar work requirements for Medicaid, arguing that the correct interpretation of current law would allow it – but the Obama administration refused their pleas.
Such was the background for Rep. Griffith’s new bill.
The bill defines “work,” for its purposes, as any of 12 different activities, including actual employment, on-the-job-training, vocational educational training, and community service programs.
“Giving this ability to the states prevents the federal government from pushing a one size fits all solution and instead gives states flexibility to best utilize their funding and help those in need,” Griffith explained.
Griffith’s bill comes even as broader Medicaid reform takes one of the leading roles in the now-hot debate over repealing and replacing the Obamacare health-policy system.
The House leadership’s Obamacare-replacement bill introduced earlier this week envisions ending the federal “entitlement” to Medicaid and replacing it with “block grant” funding to each state that would let the states themselves, within certain limits, design their own Medicaid systems for health care for lower-income Americans. (Again, this approach mirrors the 1996 welfare reform.) But the new block grants, and the policy flexibility that goes along with it, would not take effect for another three years. By contrast, Griffith’s bill would allow at least the work-requirement flexibility to be implemented as soon as the bill becomes law.
In that way, it might let states experiment with work requirements even before full flexibility goes their way as a result of Obamacare’s replacement.
Meanwhile, separately, the effort to continue reforming programs with welfare-like characteristics continues. As Rep. Griffith introduced his Medicaid-work bill on Thursday, Republican Warren Davidson of Ohio introduced a bill aimed at leading to various consolidations of some 90 different federal aid programs currently costing nearly $1 trillion each year.