Republicans want to increase the work requirements to receive Medicaid and food stamps

() — Republicans in the US House of Representatives are taking advantage of the debt-ceiling deadlock to defend one of their longstanding goals: to demand that more low-income Americans work in order to receive government benefits, particularly food stamps and Medicaid. .

Republicans see the work requirements as solving two problems, allowing them to cut government spending and bolster the nation’s workforce at a time when many businesses continue to struggle to hire.

However, the controversial policy, included in House Speaker Kevin McCarthy’s package to raise the debt ceiling, is causing some consternation within the Republican conference, with hardliners wanting to include requirements even stricter and with moderate members in swing districts worried they could face a backlash on the issue.

If the House passes the legislation this week, as McCarthy hopes, it is certain to go nowhere as the job requirements, along with other components of the bill, are fiercely opposed by the White House and Senate Democrats. But it serves as a starting point for negotiations with the Biden government on the debt ceiling.

Republican House lawmakers, including some who grew up in families that relied on public assistance, argue that work requirements can lift people out of poverty and end their dependence on the government.

Critics, however, see the mandates as an attempt to cut vital safety-net programs without regard to the millions of people who could end up having a hard time putting food on the table and meeting their health care needs. medical.

What does the plan say?

Under the package, healthy adults ages 18 to 55 without children could only get food stamps for three months out of every three years, unless they work at least 20 hours a week or meet other requirements. That mandate currently applies to people ages 18 to 49, though it was suspended during the COVID-19 public health emergency, which expires next month.

The provision would put about 900,000 people ages 50 to 55 at risk of losing their food assistance unless they work enough hours and register that employment with their state agencies, receive a waiver, or live in an area where the mandate is waived, according to the left-leaning Center on Budget and Policy Priorities.

The debt ceiling package does not go as far as some Republicans would like. Dusty Johnson, a South Dakota congressman, introduced a bill earlier this year that would force beneficiaries up to age 65 and those with children older than 7 to work. The center found that such legislation would have jeopardized food stamp benefits for more than 10 million people, including millions of children.

The debt ceiling package would also require certain adult Medicaid recipients to work, perform community service or participate in an employment program for at least 80 hours per month, or earn a minimum monthly income. It would apply to people between the ages of 19 and 55, but not to pregnant women, parents of dependent children, those physically or mentally incapacitated for employment or those enrolled in education or substance abuse programs, among others.

These are largely low-income adults who are eligible for Expansion Medicaid, a provision of the Affordable Care Act (ACA).

Medicaid has never had a work requirement, but waivers were granted under the Trump administration to several states to impose such a mandate on certain enrollees. Litigation halted or slowed states’ implementation of the effort, and the Biden administration subsequently withdrew the permits, though a federal district judge allowed the initiative to go ahead in Georgia.

According to the Congressional Budget Office (CBO), this provision would mean that an average of 1.5 million adults would lose federal funding for their Medicaid coverage. However, the states would bear the full cost of about 900,000 of them, leaving about 600,000 uninsured.

In addition, the debt ceiling bill would modify the work requirements of the Temporary Assistance for Needy Families (TANF) program, created out of the 1996 welfare reform.

fierce debate

The inclusion of this provision in the debt ceiling bill has reignited the debate about whether work requirements really help improve the lives of low-income Americans.

Supporters of welfare, who see it as a way to support work, and critics, who see it as a deterrent, each point to facts that support their views.

“Incentives matter. And today’s incentives are misplaced,” McCarthy said in a speech last week at the New York Stock Exchange. “It’s time for Americans to go back to work.”

Assistance programs are supposed to be temporary, he continued, arguing that the Republican Party’s plan will not harm the nation’s social safety net for those who need it during hard times in their lives.

There are nearly 10 million open jobs in the US, and wages for many entry-level jobs have risen in recent years, said Tarren Bragdon, CEO of the Foundation for Government Accountability, a conservative think tank that advocates for job prerequisites. So now is a good time to implement labor requirements. And when the economy takes a turn for the worse, states can apply for waivers to temporarily suspend mandates.

“The job requirements provide the deadline and incentives that we all need,” Bragdon said. “The alternative is that people are trapped in poverty in the long term.”

He pointed to Florida as an example, which — in 2016 — restored the work requirement for certain adults in the Supplemental Nutrition Assistance Program, or SNAP, as food stamps are formally known. Enrollment among this population fell 94% two years later. While the foundation’s analysis of state data shows residents took jobs in more than 1,000 industries, it doesn’t say what proportion of the laid-off registrants found work or how long it took them to get jobs.

There are differing figures for the number of food stamp program participants who are employed, depending on the data source and time period examined.

About 75% of childless, nonelderly and nondisabled adults receiving food stamps were not working, according to a Foundation analysis of pre-pandemic U.S. Department of Agriculture data.

But if we look longer term, about the same percentage of adults subject to the time limit worked in the year before or after the month they received food stamps, according to the Center on Budget and Policy Priorities. Most likely, most participated in the program during periods of unemployment.

Multiple studies have found that the existing work requirement for food stamps doesn’t help recipients get a job or increase their income, said Ed Bolen, director of the Center for State SNAP Strategies.

“We know that SNAP doesn’t help people find jobs,” he said.

The CBO’s analysis found that expanding the work requirement for food stamps may encourage some recipients to work slightly more, but would have little impact on median earnings because the loss of benefits would be equal to or greater than additional income.

As for working-age Medicaid recipients without disabilities, about 61% were working in 2021, according to the KFF, formerly known as the Kaiser Family Foundation. But many have low-wage jobs, so they can still qualify for the program in states that have expanded Medicaid coverage, where the income limit is just over $20,100 a year for an individual and $34,300. , for a family of three members.

A brief experience with Medicaid work requirements during the Trump administration showed that the mandate did not result in employment gains for recipients. Only Arkansas had the provision in place long enough for residents to be affected before it was stopped by the courts.

During those seven months, more than 18,000 low-income Arkansans lost coverage, or nearly a quarter of those subject to the mandate. Some of those who were laid off were working but were unaware of the obligation or unable to report their hours to the state agency.

The Republican Party package in the House of Representatives would jeopardize the health coverage of some 21 million people, according to an analysis published Tuesday by the United States Department of Health and Human Services. Although the vast majority of working-age Medicaid recipients work or qualify for a waiver, many may be excluded due to new reporting and administrative requirements.

According to the CBO, instituting a work requirement would mean a “very small increase” in employment, but would also increase the medical expenses of beneficiaries. However, it would reduce federal outlays on the safety net program by $135 billion, over 10 years.

“These requirements are essentially a cut in Medicaid spending,” said Laura Harker, a senior political analyst with the center’s health team.