Republicans Have Plan to Change Medicaid

Republicans have proposed a new law that would alter Medicaid and likely push millions of adults off the government-run health insurance.

The Path to Independence Act, which has nine cosponsors, would permit states to impose work requirements on able-bodied Americans enrolled in the program. At the moment, law does not force employment on such Medicaid recipients.

Thirteen states have already tried to implement work requirements for the government-run health insurance, but their efforts were blocked by President Joe Biden‘s administration. This included substantial proposals from South Dakota, Missouri, Idaho, Arkansas, Ohio and Georgia.

Former President Donald Trump originally approved the states to enforce their own work requirements, but under Biden, all existing waivers were revoked.

“The federal government should never dictate how sovereign states spend their money,” Republican U.S. Representative Matt Rosendale of Montana said in a statement.

“My Path to Independence Act will prevent state governments from going broke while encouraging individuals to be financially independent and end their reliance on government handouts. The Biden-Harris administration should have never revoked the state’s ability to set work requirements in the first place and this bill establishes a much-needed return to sanity,” Rosendale said.

Supporters of the bill argue that allowing states to utilize a work requirement for able-bodied adults can prioritize limited resources to the truly needy and help Americans become less reliant on the welfare system.

“The Path to Independence Act would guide individuals and taxpayer-funded programs down a better road—one that harnesses the power of work to change lives and fix broken budgets,” Mimi Singleton, federal affairs director at the Foundation for Government Accountability, said in a statement. “This bill is a necessary and powerful return to a fundamentally better America, putting our country and people on a path towards a more independent and prosperous future.”

Medicaid was originally founded in the 1960s to serve needy populations like low-income children, pregnant women and those living with disabilities. Once the Affordable Care Act was passed, more able-bodied adults were able to qualify. In 2000, 34 million Americans received Medicaid. By 2023, the number of recipients skyrocketed to 96 million, Rosendale’s office said in a release.

At roughly the same time, the labor participation rate has decreased, from 67.1 percent in 2000 and 62.6 percent today, according to Rosendale.

COVID-19 also triggered a substantial increase in Medicaid enrollment numbers due to the Families First Coronavirus Response Act,which increased the federal government’s share of Medicaid costs to help states during the pandemic. It also prevented states from restricting program eligibility standards or ending coverage altogether until the coronavirus was no longer declared a public health emergency.

In Rosendale’s Montana, Medicaid spending now accounts for 25 percent of the state’s spending.

Democrats have generally opposed any additional work requirements for Medicaid, saying they would make program rules more difficult to enforce while hurting Americans in the process.

Roughly 61 percent of non-elderly Medicaid beneficiaries are already employed, according to a Kaiser Family Foundation Analysis. In addition, 13 percent of recipients are not working due to caregiving needs, 11 percent because of illness or disability, and 6 percent because they’re in school.

“That leaves just a small sliver of the population that the work requirements would actually be targeting,” Mia Ives-Rublee, director for the Disability Justice Initiative at the Center for American Progress, wrote in an op-ed for CNN.

While some Republicans may be attached to the idea of work requirements for Medicaid, Alex Beene, financial literacy instructor for the University of Tennessee at Martin, said many remain opposed to the idea.

“Some Republicans have been pushing for those receiving Medicaid that are labeled ‘able-bodied adults’ to work so many hours as a requirement for their benefits,” Beene told Newsweek. “However, a national push to do something similar is unlikely. Many legislators, Democrat and Republican, understand how popular Medicaid is and wouldn’t want to tamper with it and risk angering voters.”