Medicaid Work Requirements Are Popular and Effective
A new report from The Council of Economic Advisers makes the case that work requirements should be added to non-cash welfare programs. Among many things, the report found that currently, 61 percent of Medicaid recipients are non-disabled working age adults. These are the people society generally accepts as being able to work. Approximately 60 percent of Medicaid, housing-assisted non-disabled working-age recipients work fewer than 20 hours per week. According to research from the Foundation for Government Accountability (FGA), "just 16 percent of able-bodied Medicaid enrollees work full time, year round."
A 2018 survey from the FGA found that 90 percent of likely voters supported the idea that able-bodied adults should have to work or train part time to receive their welfare benefits. In that same poll 82 percent of Democrat voters supported work requirements. 75 percent of respondents supported a work requirement to receive Medicaid. 89 percent of all voters supported a work requirement to move able bodied Americans off welfare and towards being self sufficient. While funding for welfare programs continues to stress budgets, nearly 30 million able-bodied Americans continue to receive benefits with no work requirement.
While work requirements are in place for some welfare programs, Medicaid specifically lacks any strong work requirements for able-bodied adults. Programs like food stamps require that able-bodied, childless adults
work, train or volunteer at least 20 hours per week. For Medicaid recipients, as long as they have an income below a threshold they can remain dependent on the assistance. During the 2000's Medicaid enrollment boomed, more than doubling to 75 million from 2000 to 2018. Medicaid spending on able-bodied adults has increased by 700 percent from 2000.
By requiring work, we can move people away from dependence to towards a life of self support. In the few states that have been able to implement work requirements for Medicaid recipients, they have seen early success. Kansas and Maine both saw drops in enrollment and increases in former enrollees incomes. Income gains far outpaced loses from welfare in Kansas, where incomes of former enrollees were doubling.
So the question should not be whether these programs are popular but rather if we think someone having a job is a good thing. It is clear from the few states that have implemented work requirements that getting someone back to work is a good thing. For a state like Kentucky that ranks 44th in workforce participation, despite a historically low unemployment rate, getting people back to work should be viewed positively.
You can read the full report from the Council of Economic Advisers here