In a move critics denounced as an effort to "stigmatize the poor" and undermine a life-saving component of the social safety net, the Trump administration on Thursday issued guidance that would for the first time allow states to force work or performance requirements on Medicaid recipients.
While Seema Verma, head of the Centers for Medicare and Medicaid Services, euphemistically described the new guidance as an effort to "transform Medicaid," analysts argued that the policy shift is little more than a "sneak attack" on an extremely popular program that provides crucial medical coverage to over 70 million Americans.
"This is just the latest in Trump and Republicans' relentless assault on Medicaid and the broader set of federal programs people rely on. And it's a sign that there is likely more to come," observed Chad Bolt, senior policy manager at Indivisible.
Who could lose their health coverage as a result of this new guidance? People who:— Chad Bolt (@chadderr) January 11, 2018
-can't find work
-live in areas of persistent unemployment
-got laid off during a recession
-have seasonal jobs
-don't get as many hours from their employer as they want 7/
As Common Dreams has reported, President Donald Trump and the Republican Party have been eyeing cuts to the already diminished safety net for months, and progressives have repeatedly warned that the deficit-exploding GOP tax plan -- signed into law just after Christmas -- would serve as a vehicle for draconian changes to Medicare, Medicaid, and Social Security.
Even before the Trump administration's guidance was issued on Thursday, ten states -- including Maine, Arkansas, Indiana, Kansas, and Kentucky -- had already requested a federal "waiver" to impose work requirements on Medicaid recipients, and more are likely to follow suit in the coming weeks.
"To qualify for a waiver, a state must provide a convincing justification that its experiment would 'further the objectives' of Medicaid," notes the Washington Post's Amy Goldstein.
Health policy experts were quick to argue that Trump's new policy will do precisely the opposite.
"Work requirements don't help the unemployed or underemployed find work," Bolt notes, "it punishes them when they're down -- which is exactly what the Trump administration wants to do."
BREAKING: Trump administration is allowing states to terminate automatic, guaranteed Medicaid coverage for people with disabilities, the medically frail, and people who can't find jobs. This is truly savage. https://t.co/5bVPUZCACM— Topher Spiro (@TopherSpiro) January 11, 2018
In addition to slamming the cruelty of the policy shift, analysts also poked holes in the assumptions being used to justify it.
Contrary to the right-wing trope that recipients of Medicaid are unemployed moochers, a Kaiser Family Foundation study published last month found that 80 percent of adult Medicaid recipients "live in working families, and a majority are working themselves."
"Among the adult Medicaid enrollees who were not working, most report major impediments to their ability to work including illness or disability or care-giving responsibilities," the study adds.
If Republicans truly cared about punishing "lazy" individuals soaking up money without having to work for it, they would be focusing their attention on "the idle rich," argued the Washington Post's Elizabeth Bruenig in a recent column.
"They soak up plenty of unearned money from the economy, in the form of rent, dividends and capital income," Bruenig wrote. "And yet rarely do politicians inveigh against the laziness of the well-off. In fact, the government shells out huge sums of money to the rich every year through tax breaks and subsidies."
Echoing Bruenig in a tweet on Wednesday, Roosevelt Institute fellow Michael Linden concluded, "There is perhaps no better example of the moral rot at the core of the Republican Party than imposing so-called 'work requirements' on sick Medicaid recipients just weeks after passing a massive tax cut for rich heirs who literally did no work at all to inherit their wealth."