At Least Work Requirements for Medicaid Are Now in ‘RyanCare’

(Quin Hillyer, Liberty Headlines) The idea of requiring work or education in return for Medicaid benefits may be catching on.

CONGRESSMAN: Recipients Should Work to Get Medicaid Benefits

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A bill allowing states to impose such requirements, reported here at Liberty Headlines a week ago, has now been incorporated into the Obamacare replacement legislation that is expected to receive a vote in the U.S. House of Representatives on Thursday.

Its inclusion, by name, in Speaker Paul Ryan’s “manager’s amendment” already is being credited with attracting significantly more support for the overall legislation from conservative House members.

PREVIOUSLY: Congressman Says Recipients Should Work to Get Medicaid Benefits


The original work-requirement bill was introduced March 9 by Republican Rep. Morgan Griffith of Virginia. Modeled largely on successful provisions of the 1996 welfare reform bill that cut traditional welfare rolls in half, the bill 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.

Even before the new “work provisions” were officially included in the manager’s amendment, the promise that they would be included helped sway at least one documented conservative opponent into support to move the bill to the Senate for further consideration. Sophomore Republican Gary Palmer of Alabama, a policy expert who ran a conservative think tank for 25 years, had voted against Speaker Ryan’s original bill when it was presented last week to the Budget Committee. But after President Trump pledged to ensure that work requirements would be included, Palmer announced he would support the bill.

(In the earlier Budget Committee meeting, Palmer successfully authored a motion to allow work requirements, but it was merely a non-binding “sense of the committee,” so he still awaited confirmation that the change would be made in the bill itself.)

Another key group of conservatives, the Republican Study Committee, also were swayed from skepticism to support because of the inclusion of work requirements (along with a provision letting states choose a different funding mechanism known as block grants). As the Capitol Hill newspaper Roll Call reported, “All but one of the 17 RSC Steering Committee members (not counting four ex-officio members) have committed to voting yes on the bill, eight or nine of whom had shifted from a no or leaning no because of the Medicaid changes, RSC Chairman Mark Walker told reporters at the Capitol.”

Republican Whip Steve Scalise explained the agreement will not just allow states to impose work requirements, but also provide incentives for them to do so.

Still, leaders of another group of even harder-line conservatives, the House Freedom Caucus, said the incentives aren’t enough. The group’s chair, Republican Mark Meadows of North Carolina, said as long as the states have the “option,” but not the absolute “mandate,” to include work requirements, the provision isn’t strong enough. For those and other reasons, Meadows and many of his Freedom Caucus compatriots remain opposed to the bill.

Nonetheless, the incorporation of almost an entire new bill into larger, major legislation, less than two weeks after the bill was first introduced, is a mark of how popular its central idea is among Republicans. The official four-page summary of the manager’s amendment explains: “The amendment adopts the language from Mr. Griffith’s bill, H.R. 1381, which was modeled after the requirements and exemptions that exist in [the main workfare program] under current [welfare] law. States could begin using this new option on October 1, 2017. The amendment grants broad flexibility to states to implement the requirement as they see fit.”

The work requirements are not the only part of the manager’s amendment that are designed to attract more conservative support. The amendment also speeds some of the tax repeals that Ryan’s bill originally waited two years to repeal, and more            quickly curtails the ability of states to further expand Medicaid eligibility.

Still, because the Speaker’s legislation leaves many Obamacare regulations in place (to be dealt with in a later bill), conservatives such as Meadows vow to defeat it. Speaker Ryan and President Trump are reportedly working the phone lines to gather support for their bill, which is expected to result in a close vote, either way, on Thursday.