President Trump wrongly stigmatizes the poor with plans for Medicaid work requirement
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President TrumpDonald TrumpHillicon Valley — State Dept. employees targets of spyware Ohio Republican Party meeting ends abruptly over anti-DeWine protesters Jan. 6 panel faces new test as first witness pleads the Fifth MORE took another shot at America’s working poor and their health last Thursday by allowing states to impose unnecessary and unprecedented work requirements in the Medicaid program, a vital lifeline for millions of families. 

That policy change, quickly embraced by the state of Kentucky, would be a disaster for the 70 million people who rely on Medicaid to see a doctor, get their prescriptions, and heal after an injury or illness. The last thing low-income Americans need is another hoop to jump through just to get health care.


The justification for this unnecessary requirement is based on a blatant lie. Nearly sixty percent of Medicaid recipients already work, per the Kaiser Family Foundation, and eight out of ten live in working families. What’s more, according to the Center on Budget and Policy Priorities, most Medicaid recipients who do not work have legitimate reasons. Of the non-working, non-elderly adult Medicaid recipients who were unemployed in 2016, 36 percent were ill or disabled, 30 percent were taking care of family or a home and 15 percent were in school. Trump’s proposed work requirement is a politically motivated attack that is meant to undermine an ObamaCare program that has only grown in popularity with every attack on the ACA. By stigmatizing Medicaid recipients, just as radical conservatives have done for welfare recipients, by implying that they are abusing the program and therefore unworthy of our help the administration and its allies are clearly attempting to weaken support for the program.

Why now? Medicaid is more popular than ever, and for good reason. States that have expanded access to the program are finding it has significantly improved the health and financial stability of its citizens. In just a two-year period, Medicaid expansion under the Affordable Care Act (ACA) saved 50,000 Americans from bankruptcy and reduced the number of people going into debt from medical bills by about 40 percent, the National Bureau of Economic Research found. Expansion has helped rural hospitals stay afloat, providing a much-needed boost to health facilities in states like Coloradoallowing new patients to seek treatment. 

Medicaid expansion also has played a key role in combatting the opioid epidemic. It is not a coincidence that states that expanded Medicaid have also reduced the unmet need for treatment of substance abuse disorders by 18 percent. Said Republican Ohio Gov. John Kasich: “Thank God we expanded Medicaid because that Medicaid money is helping to rehab people.”

Kentucky, which announced last Friday it will move forward with implementing work requirements, was a Medicaid expansion success story under its previously Democratic governor. Between 2013 and 2015, Kentucky’s uninsured population plummeted from 40 percent to 9 percent; low-income citizens reported more primary and preventative-care and fewer emergency room visits. Now, as Republican Gov. Matt Bevin follows Trump’s lead, at least 100,000 people could lose that care.  On top of that, the regulations themselves – such as a finance or health exam requirement - are clearly designed to signal that Medicaid recipients are irresponsible with their money or health, though all the evidence demonstrates the opposite. 

The president’s political ploy to undermine Medicaid might play to his base of supporters, but there’s reason to believe it could backfire at the ballot box. Last November, people in Maine voted on a ballot initiative to expand Medicaid to 70,000 more citizens. That was after Republican Gov. Paul LePage on five separate occasions vetoed legislation to expand Medicaid. Mainers showed they believe everyone should have access to health care, and took matters into their own hands. They put Question 2 on the ballot and decided that people shouldn’t have to choose between feeding themselves and healing themselves.

Maine showed the extent to which Americans value Medicaid – a program that has steadily grown in popularity, with over 60 percent of Americans saying it should continue unchanged – and are willing to vote for it. And that victory was just a start. In 2018, more states will put Medicaid expansion on the ballot, as citizens across the country go on the offense to improve their quality of life.  

So while the president sent a message last week that he is willing to make it harder for people to get health care, voters are gearing up to send the opposite message: that they value Medicaid, that they want to expand health care coverage to more people, and that they are fed up with the broken politics that shames poor people to undermine a program that is working.

Jonathan Schleifer is executive director of the Fairness Project.