OPINION: Republican Medicaid plan shows how to make work requirements work right
These reforms passed in a bipartisan fashion because we made the case that fixing these programs were a moral imperative more than a fiscal one.
Republicans, along with most Americans, understood that work is essential for lifting people out of poverty. Our reforms re-centered the welfare system around the importance of work and rewarding people for working. Including work requirements in Medicaid would build on that success. There is ample evidence that Medicaid coverage without work requirements creates a disincentive to work. In 2005, Tennessee disenrolled 170,000 individuals — 91% of whom were childless adults. A 2013 analysis from NBER found"an immediate increase in job search behavior and a steady rise in both employment and health insurance coverage.
Work requirements for public assistance programs are also important to maintaining public support for the programs. Americans are compassionate people, but they believe those receiving benefits have responsibilities. One idea would be to require Medicaid enrollees to complete an annual physical or health screening to maintain coverage. Since catching health issues early leads to better health outcomes and less overall spending, this requirement to practice preventive medicine would be better both for the Medicaid recipient and the taxpayer.
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