The Trump Plan to Hurt the Poor by Pretending to Help Them


Julianna Brion

When Ohio and Michigan expanded their Medicaid programs to broaden coverage, residents who became eligible found it easier to look for work, according to studies by the Ohio Department of Medicaid and the University of Michigan. That’s because having Medicaid gave them access to primary care doctors and prescription medicine that helped them live normal lives and get jobs.

That’s how you help people in the real world. The Trump administration said Thursday that it would get poor people to work by letting state governments deny them Medicaid if they don’t have a job.

The Centers for Medicare and Medicaid Services argues that this draconian step will encourage more Medicaid beneficiaries to get a job and thus “promote better mental, physical and emotional health.” There’s no evidence that this is true, and the data from Michigan and Ohio shows that it contradicts the truth. There is good reason to worry that fewer people will have a job in states that adopt this cruel policy.

Arkansas, Indiana, Kentucky and seven other states are seeking waivers from federal law to initiate the policy, and the agency says it is ready to grant them the waivers in the coming days if the states meet certain minimal conditions, like exempting people who are pregnant, disabled or caring for family members.

The new policy would be attempting to solve a problem that doesn’t exist. About two-thirds of Medicaid beneficiaries are either seniors, disabled people or children. Of the remaining one-third, nearly 80 percent are in families with at least one working person and 60 percent have full- or part-time jobs, according to the Kaiser Family Foundation. This policy change is merely a bureaucratic obstacle to keep poor people from obtaining Medicaid. Eligibility for the program varies from state to state, but the national median income limit for a single person to qualify for Medicaid is $16,642 a year.

Republican lawmakers who have demonized the program as welfare for “able-bodied adults” have long sought to require Medicaid beneficiaries to work. Those lawmakers have been particularly angry about the expansion of Medicaid under the Affordable Care Act, which they have been trying to repeal since it was passed in 2010.

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