On Jan. 12, New York Times columnist Paul Krugman, an alleged “expert” on economics and healthcare, claimed Republicans’ attempts to reform safety-net programs are “about the cruelty” not “the money.” But reforming social programs is about neither. Krugman knows that, but he’s more interested in destroying President Trump and congressional Republicans than he is in telling the truth.
In his article for the Times, titled “Dollars, Cents and Republican Sadism,” Krugman writes, “Over the past few years it has become increasingly clear that the suffering imposed by Republican opposition to safety-net programs isn’t a bug, it’s a feature. Inflicting pain is the point.”
Krugman then points to three “stories about health care policies” as proof. Although all of them contain misleading statements, his assault on Medicaid work requirements is particularly egregious.
On Jan. 11, the Trump administration issued a new guidance to state governments allowing them for the first time to implement work requirements for able-bodied Medicaid recipients. Under the new policy, states can apply for waivers that would allow them to require nondisabled adults to obtain a job, pursue education, enroll in job training, or volunteer in order to remain enrolled in Medicaid.
Krugman laments the Trump administration’s decision, saying “a vast majority of those who aren’t working have very good reasons for not being in the labor force: They’re disabled, they’re caregivers to other family members, or they’re students.”
Why would the Trump administration and Republicans support such measures? Well, because they want to hurt poor people, of course!
“The answer, surely, is that it isn’t about saving money, it’s about stigmatizing those who receive government aid, forcing them to jump through hoops to prove their neediness. Again, the pain is the point,” Krugman wrote.
Krugman’s interpretation of the letter issued by the Centers for Medicare and Medicaid Services is beyond puzzling. The guidance issued by CMS specifically says the work requirements created by states can only apply to “non-elderly, non-pregnant adult Medicaid beneficiaries who are eligible for Medicaid on a basis other than disability.” It also says among the activities that should satisfy the work requirements are “skills training, education, job search, caregiving, [and] volunteer service.”
By providing a list of people Krugman says need Medicaid while criticizing the CMS guidance, Krugman gives the false impression — possibly inadvertently — that those he lists will now be forced to work. As the quoted sections of the CMS letter listed above show, however, that’s not the case.
Krugman argues, “The population of Medicaid recipients who ‘ought’ to be working but aren’t is very small, and the money that states could save by denying them coverage is trivial.”
Even if that were true, and I don’t believe it is, Krugman is effectively arguing that because the number of people who might be abusing the system is small, we should continue allowing them to abuse the system or receive benefits without having to contribute anything at all in return.
It’s important to remember the CMS guidance doesn’t mandate people must find jobs, but rather that states can mandate they must do something to benefit society and improve their own situation, including volunteering or pursuing an academic degree. Since when is asking people to volunteer or go to college while they receive free or subsidized health insurance considered “inflicting pain”?
Further, work and community-engagement requirements have nothing to do with “forcing [recipients] to jump through hoops to prove their neediness.” Work requirements are about helping able-bodied people move away from government dependency and toward self-sufficiency. They literally have no connection to proving “neediness.” Even if they did, however, what’s wrong with making sure those who are on Medicaid really need it? Is Krugman suggesting there is absolutely no abuse in welfare programs?
Krugman’s assertion that work requirements won’t save any money is also false. The Foundation for Government Accountability projects Medicaid work requirements would reduce enrollment by 13.6 million by fiscal year 2027, saving nearly $1 trillion over the next decade. Even if work requirements only save one-tenth of the projected $1 trillion, it would still mean more than a million people would no longer be dependent on Medicaid and more than $100 billion would be saved.
To maintain costly programs like Medicaid, and ensure their existence for decades to come, it’s vital only those who truly need to receive assistance do so. By limiting work-free Medicaid programs to the disabled, elderly, children, and those with debilitating illnesses, Medicaid isn’t being weakened, as Krugman suggests; it’s strengthened, and its long-term viability is ensured.
Everything Krugman claims as proof of Republicans’ heartless disposition on Medicaid work requirements is false or misleading. Krugman should spend more time debating and discussing facts and less time distorting them, as he did in his recent article.
Justin Haskins (@JustinTHaskins) is a contributor to the Washington Examiner’s Beltway Confidential blog. He is an executive editor at the Heartland Institute.
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