The new Republican provision to allow states to deny health assistance for lacking employment will only make the program worse.
Stretching back to the establishment of welfare in the United States, politicians have debated both the practical and moral utility of requiring people to work in order to receive government benefits. Since welfare reform in the 1990s gave states wide latitude to create work requirements in the Temporary Assistance for Needy Families cash-assistance program, Republicans have hankered for a chance to extend those requirements to other safety-net programs, as part of their push to “require everyone who can to work.”
The purpose of work requirements in welfare, according to the Congressional Research Service, is “to offset work disincentives in social assistance programs, promote a culture of work over dependency, and prioritize governmental resources,” in addition to helping lift people out of poverty.
Now, Republicans could take one step closer to having that chance, thanks to a last-minute manager’s amendment that was attached to the GOP’s Obamacare repeal-and-replace bill by House Speaker Paul Ryan. In a fashion similar to TANF, the amendment would give states authority to mandate that “non-disabled, non-elderly, [and] non-pregnant” individuals enrolled in Medicaid engage in some amount of hours of “work activities.”