President Joe Biden
signed
a measure on Saturday that suspended the country’s debt limit after weeks of wrangling with Republicans in the House. The legislation
averts a default
on the nation’s debt. Democrats managed to keep
Medicaid work requirements
out of the
final compromise
. That’s a shame.
The proposal would have helped rein in federal spending while preserving the entitlement for the truly needy. The
work requirements
would have compelled people between the ages of 19 and 55 to work, perform job training, or do community service for at least 80 hours each month in exchange for Medicaid benefits. Recipients with barriers to work, such as disabled people and those with children or other dependents, would have been exempt from the requirements.
It hardly seems unreasonable to ask able-bodied adults to participate in the economy for just 20 hours per week in exchange for taxpayer-funded health coverage. After all, that insurance isn’t cheap.
Medicaid accounts for
$1 of every $6
spent on healthcare in this country. The entitlement cost
$734 billion
in 2021, the latest year for which federal data are available. Costs are only going up. The Centers for Medicare and Medicaid Services
estimate
Medicaid spending will exceed $1 trillion in 2028. That’s partly because enrollment is skyrocketing. Between 2013 and 2020,
14 million
people
were newly enrolled in Medicaid. Since February 2020,
21 million beneficiaries
have been added to the program.
Many of them aren’t the truly needy people (pregnant women, adults with dependents, and disabled people) for which the program was originally intended. As more able-bodied adults join Medicaid, they compete for the scarce medical appointments available to its beneficiaries.
Many providers limit the number of Medicaid patients they’ll see, given the program’s low reimbursement rates. The result can be long waits for routine care.
Implementing work requirements would help trim Medicaid enrollment while saving taxpayers money. It deserves to remain a priority not just for Congress but for state legislators too.
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Sally C. Pipes is president, CEO, and Thomas W. Smith fellow in healthcare policy at the Pacific Research Institute. Her latest book is
False Premise, False Promise: The Disastrous Reality of Medicare for All
(Encounter 2020). Follow her on Twitter
@sallypipes
.
