For many progressives, Medicaid is viewed as health insurance. Everybody who needs it, they argue, should have a right to it. That’s not why the program was created, however, and the Trump administration moved this week to bring it more in line with its original mission.
When it was implemented in 1965, Medicaid was intended to help low-income seniors, as well as families who needed temporary assistance. It was not a permanent subsidy — especially for those capable of working. Along those lines, the Trump administration this week presented new guidelines that allow states for the first time to impose work requirements for the federal-state partnership.
As The Associated Press points out, Medicaid now covers more than 70 million people, or roughly one in five Americans, and is the nation’s largest health insurance program.
Medicaid beneficiaries range from pregnant women and newborns to elderly nursing home residents. The program was expanded under former President Barack Obama with an option that allows states to cover millions more low-income adults. Nevada and many other states took the money and have seen an explosion in the Medicaid rolls.
Many beneficiaries have jobs that don’t provide health insurance. And while people aren’t legally required to be employed to receive benefits, states can seek federal waivers to implement reforms. The president’s move makes clear his administration will look more favorably on such requests.
According to the Trump administration, 10 states have already applied for Medicaid waivers involving work requirements or community involvement.
As Ed Morrissey of HotAir.com reports, Seema Verma, head of the Centers for Medicare and Medicaid Services, told state Medicaid officials in November that the Obama administration had wrongly focused on increasing Medicaid enrollment, rather than helping people move out of poverty and into jobs that provide health insurance. She told the AP this week that requiring work or community involvement can make a positive difference in people’s lives, as well as in their health. “We see people moving off of Medicaid as a good outcome,” she said.
The administration believes work requirements for Medicaid should mirror those for other programs such as food stamps and welfare. And even the administration’s new approach simply gives states more options — without mandating anything — critics are deriding the move and threatening lawsuits.
In fact, though, Ms. Verma has it right. The goal shouldn’t be promoting lifetime dependency, but providing a temporary safety net while helping people become self-sufficient and gainfully employed. The Trump administration’s willingness to grant states more flexibility regarding Medicaid is a step in the right direction.