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OPED: 'Work requirement' bills are a cruel election-year ploy
Republicans are rushing legislation to create “work requirements” for recipients of Medicaid and the Supplemental Nutrition Assistant Program (SNAP), also known as food stamps through the General Assembly. A bill to create “work requirements” for Medicaid may be voted on as early as Monday. Similar legislation for SNAP will likely be considered shortly thereafter.
The Republican rationale for work requirements rests on the old, stereotypical (and false) idea that those who rely on the social safety net are unwilling to work because they are lazy or because the very existence of the safety net creates a “culture of dependency” that discourages work. It assumes that people with low-incomes are different from, and less deserving than, the rest of us. And, between the lines, supporters of this legislation imply that the recipients of Medicaid and SNAP are urban, people of color.
None of these assumptions are true.
Most recipients of Medicaid and food stamps are white. The rate of usage of both programs are roughly the same in rural and suburban areas as in urban areas. And the vast majority of Medicaid recipients and SNAP work.
In Pennsylvania, 64 percent of Medicaid recipients work at any one time and there is a worker in 79 percent of the families of Medicaid recipients. Nationwide, 52 percent of SNAP recipients work. Nationwide, 77 percent of families that receive SNAP — and in Pennsylvania, 74 percent — have at least one worker.
Moreover, people who benefit from safety net programs typically work in fields with unstable employment. A recent study of SNAP recipients by the Center for Budget and Policy Priorities showed that while 50 percent of SNAP recipients work at one time, 74 percent work at some point in a year.
Additionally, social safety net programs are not a “way of life” for Americans able to work. A long-term study of safety net recipients in 2015 showed that 36 percent of Medicaid recipients and 30 percent of SNAP recipients received benefits for one year or less in a four-year period. About 51 percent of Medicaid recipients and 48 percent of SNAP recipients received benefits for two years or less in that period.
Why don’t all Medicaid and SNAP recipients hold jobs? The reasons vary, but they are essentially the same as the reasons that only about around 60 percent of adult Pennsylvanians work. According to the Kaiser Foundation, 36 percent of Medicaid recipients who do not work were ill or disabled, 30 percent were taking care of family members, 15 percent were going to school and 6 precent could not find work. The Center for Budget and Policy Priorities found similar results in a study of SNAP recipients.
Most of us would accept those as reasonable grounds for not working among those who do not receive Medicaid or SNAP. Why do we expect something different from those who do benefit from these programs?
It’s not an answer to say that only Medicaid and SNAP recipients get government benefits. Everyone in America gets support from the government to secure health insurance. The “non-working” spouse of a CEO taking care of a young child gets a huge tax break on their health insurance. The “non-working” spouse of a janitor for the same company taking care of a young child gets Medicaid. Why do Republican legislators want to take health insurance from the spouse of the janitor?
The legislators who constantly complain about red-tape and bureaucracy are the ones eager to institute onerous rules that many people entitled to SNAP and Medicaid will be unable to meet. Too many working recipients of Medicaid and SNAP will find it hard to fill out the required paper work twice a year. So will the large percentage of Medicaid recipients who suffer from mental illness and opioid addiction.
This cruel policy will not even save the state money. The federal government pays for SNAP and for 90 percent of the cost for those likely to lose Medicaid. Between the tens of millions of dollars needed to administer it and the hundreds of millions of dollars needed to provide work and other supports, the state will likely lose money. And if, as Kentucky expects, work requirements lead to a 15 percent decline in the Medicaid population, Pennsylvania doctors and hospitals will lose between $500 and $900 million in federal reimbursements. That will drive up health insurance costs for everyone.
These bills are an election-year ploy designed to appeal to voters who embrace the false and cruel narrative about the safety net. It’s time for all of us to tell legislators to reject that false narrative and legislation derived from it.
— Marc Stier is the Director of the Pennsylvania Budget and Policy Center.