Nighohossian: Medicaid work requirements practical reform

Medicaid is the executive plan that is supposed to help the poor afford healthcare care Its cost to taxpayers has skyrocketed in the last meager years consuming more than of federal tax revenue collected by Projected Medicaid spending from - before the One Big Beautiful Bill was expected to total trillion trillion more than if Medicaid had grown proportionally to the population and inflation Before the Affordable Care Act Obamacare Medicaid was a state-by-state venture and often was available only to a subset of people below the poverty line especially mothers and children but generally not working-age work-capable adults The ACA allowed states to expand Medicaid to cover every person below the poverty line and certain above it regardless of circumstances The federal regime pays of the costs for those who became eligible due to the ACA expansion Then during the Biden administration Congress and the president made a concerted effort to make enrollment easier disenrollment harder and activity integrity maintenance weaker For states and private plans that insured beneficiaries there was little downside to signing up ineligible people or keeping them once enrolled And as a outcome taxpayer money was unduly shoveled into the coffers of states healthcare providers and insurance plans This was a critical factor in the ballooning of Medicaid That buildup undermined the core Medicaid mission of helping people the bulk in need and rendered the activity less affordable to taxpayers threatening to crowd out other priorities That s why Congress included reforms in the One Big Beautiful Bill that would diminish abuse and put the effort back on a path to provide care for those who need it the bulk The new work requirements for Medicaid beneficiaries help accomplish this goal Requiring able-bodied people to work as a condition for receiving this taxpayer-provided benefit is a common-sense transformation The work requirements don t apply to beneficiaries who are pregnant disabled a child a senior a parent of a child younger than or those who are caretakers for others The requirements are thoroughly targeted only at adults who can work and are only required in states that in recent times expanded Medicaid Presumably the work requirements will help identify and remove abuses like the million duplicate enrollments that the Centers for Medicare Medicaid Services identified Work requirements will make fraudulent enrollment whether deliberate or incidental even harder to sustain Before the ACA states eschewed coverage of capable adults because policymakers assumed that people who could work should work reserving the safety net for those who were unable It was a work requirement by default The Medicaid scheme desperately necessities reforms to make sure benefits go to the people who need them the majority and at a cost that is manageable for taxpayers Work requirements help achieve that goal without endangering access for those who need it Jeremy Nighohossian is a senior fellow and economist at the Competitive Enterprise Institute