Are Work Requirements for Medicaid Worth It? (Opinion)


Jon Tyson

Speaker McCarthy’s proposal to raise the debt ceiling includes work requirements for recipients of Medicaid. This could disproportionately affect people with disabilities, the impoverished, minority racial groups, and caretakers. How will this go over in the houses of Congress? What does this look like for typically American households?

Last month, many members of the House voted to require work requirements in order to be eligible for Medicaid. Supporters of this movement, overwhelmingly Republican, were led by a bill proposed by Kevin McCarthy, 55th Speaker of the United States House of Representatives. Some are concerned that this would result in 600,000 citizens losing insurance, but others suggest it is a necessary means to raise the debt ceiling. Is it worth it?

Medicaid is expensive. This bill is projected to minimize spending $109 billion in the upcoming decade, but it will cost billions of dollars state by state to implement. The Center on Budget and Policy Priorities cites, “In a fact sheet released along with the bill, Speaker McCarthy indicates that the cuts to Medicaid, SNAP, and TANF would total $120 billion over the next decade. These cuts are nearly identical to the cost associated with the bill’s provisions to hinder IRS enforcement efforts, which CBO has previously estimated would be about $114 billion over ten years as less legally owed revenue would be collected.”

An earlier publication on El Cid suggested, “If Congress does not raise the debt ceiling and allow the federal government to borrow money to pay its bills, the United States could default on its obligations. This could lead to a recession and cause global financial markets to plummet.”

It is also worth noting that McCarthy’s Republicans hold the majority in the House, but the Democrats outweigh the Senate by 51-49. Any agreement to resolve debt ceilings must pass both houses of Congress. However, this is unlikely considering the primary two objectives of McCarthy’s proposals are resented by the democrats, these being work requirements and spending cuts.

The Republican agenda suggests that those benefiting from Medicaid have no incentive to work or earn money independently. This creates a stigma around those who qualify for this coverage. However, this is generally not the case, in fact, CNN reports, “According to a Kaiser Family Foundation analysis of 2021 federal survey data, 61% of non-elderly Medicaid recipients already work, 13% were not working due to caregiving, 11% were not working due to an illness or disability, and 6% were not working due to school.”

By revoking these resources, McCarthy effectively punishes those going to school to further their career by getting the necessary education. The Center on Budget and Policy Priorities notes, “Because people of color often face more barriers to education as well as employment discrimination, they are more likely to receive Medicaid, SNAP, or TANF cash assistance benefits, which means that while policies that take away this help from people who need it affect people of all races and ethnicities, they disproportionately affect people of color.”

Additionally, it could reduce coverage for those with long term disabilities. Just two months ago my father suffered a debilitating hemorrhagic stroke. He had to be life-flighted to a hospital an hour away and remained in the Trauma Intensive Care Unit for weeks, services that would cost hundreds of thousands of dollars without insurance. During this time, he had several incubations and additional emergency surgeries including a tracheostomy and gastrostomy. My father was not covered by insurance because his source of income was independent, making insurance in America too expensive to sustain. Without Medi-Cal, my father would have been stripped of the resources that kept him alive. He would not have been able to afford the Sub-Acute rehabilitation center that he resides in currently. If this bill by McCarthy is put in action, my father and many Americans like him, who will suffer from lifelong disabilities, may not qualify for the coverage to sustain their needs because they are incapable of working for salaries. Even if my dad builds back capabilities, he is bound to struggle rebuilding a career so late in his life— especially after losing years to the hospitalization and rehabilitation processes. This would put him at a disadvantage regardless of his electability for Disability resources.

Medicaid’s stated mission within the Social Security Act is to provide “medical assistance on behalf of families with dependent children and of aged, blind, or disabled individuals, whose income and resources are insufficient to meet the costs of necessary medical services.” Is it worth compromising this to raise the debt ceiling?

Work requirements disproportionately hurt low income families, especially those from minority or immigrant backgrounds. The reality is that Americans will be forced to work low income jobs to meet these requirements, especially if they are caregivers, have health issues, or are uneducated. The impoverished will be further disadvantaged by the American healthcare system. Health care is a human right. And yes, caregivers are human— and some of the most hardworking at that. The impoverished are human. Immigrants and minority populations are humans. And, the disabled are human. My father deserves to be treated as a human.