Debate over whether or not to expand Medicaid welfare under the provisions set forth in the federal Affordable Care Act, or ObamaCare, is reaching a fever pitch in the states that have so far rejected the expansion, as federal funding is set to wind down after 2016.
The problems with ObamaCare Medicaid expansion have been well documented. States that expand the welfare program to enroll non-disabled, childless adults put at risk the Medicaid safety net for truly vulnerable patients and families and jeopardize funding for other critical state priorities such as public safety, education and infrastructure.
The absence of work requirements for the new Medicaid welfare expansion population makes these problems worse. Unlike other taxpayer-funded welfare programs, including cash assistance from the Temporary Assistance for Needy Families (TANF) program and food stamps from the Supplemental Nutrition Assistance Program (SNAP), Medicaid enrollees are not required to work—or even search for work. This decision runs counter to the success work requirements have had in helping lift people off government dependency, out of poverty and into self-sufficiency and independence.
Despite the decades-long record of success work requirements boast, the Obama administration has so far rejected every request made by a state to incorporate them into so-called alternatives to Medicaid welfare expansion.
While work requirements would be an improvement to an otherwise devastating expansion of Medicaid welfare, they cannot turn a terrible policy into a good one. Even with work requirements, ObamaCare’s Medicaid expansion still creates a new entitlement for non-disabled, childless adults who have never qualified for other types of long-term welfare. ObamaCare’s perverse funding formula still prioritizes this new population of able-bodied adults over the truly needy. The federal government is still unlikely to keep its funding promises to the states. Work requirements change none of this.
But they remain a positive component of a temporary and targeted welfare program that lawmakers should closely consider. Most important, they create a critical incentive for individuals to improve their own station without indefinite dependence on government.