New paradigm?

Work requirements for Medicaid will start in Indiana, Kentucky

By —— Bio and Archives--February 6, 2018

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Work requirements for Medicaid will start in Indiana, Kentucky
When you really think about it, it seems astonishing that anyone would object to this. But politics being what it is, you’re not astonished at all, because the capacity of political people to disregard obvious truth is almost unlimited.

If you’re on Medicaid, it’s because you can’t afford your own health care or health insurance. The point of public assistance should be not to merely give you things, but to assist you in reaching the point where you can be self-sufficient. To the extent access to Medicaid would be tied to a connection with opportunity, that would seem to be something people of all ideological stripes could universally applaud. I’m not sure why all 50 states are not chomping at the bit to sign up for this, but for now only two have taken the leap:

Indiana on Friday became the second state to gain approval for imposing work requirements on Medicaid beneficiaries, a sign that the Trump administration is maintaining a rapid pace for granting changes that will put a conservative imprint on the program.

The approval, the first major health-policy move since Alex Azar was sworn in Monday as Health and Human Services secretary, suggests continued support under his leadership for work-related mandates in Medicaid, the federal-state health program for the low-income and disabled.

Mr. Azar, who traveled to Indiana for an event with Gov. Eric Holcomb, said the work-related requirement would apply only to a small segment of Indiana’s Medicaid enrollees.

“It recognizes Medicaid can become a way out of poverty,” said Mr. Azar, adding that a “sense of purpose” comes from work. “Work is a key component of well-being.”

About a dozen states, including Arizona, North Carolina, Utah and Wisconsin, also are in discussions with HHS about work-related and other mandates in Medicaid, federal officials said.

Indiana joins Kentucky in requiring some Medicaid recipients to find jobs or undertake related activities like training or community work to avoid being suspended from coverage. The new requirement begins in 2019.

At the heart of left-wing objections

At the heart of left-wing objections to this will be the claim that it’s unfair to people who have tried to find work but just can’t. The problem with that argument is that it assumes finding work is little more than a stroke of luck - and that those who are gainfully employed weren’t any more earnest or effective in their approach to finding and keeping a job. Liberals often like to say that those who are doing well in life are merely “the winners of life’s lottery,” as if your own actions have nothing to do with it.

Real-life experience, of course, tells us this is not the case at all. People who consistently maintain good habits and pursue opportunities with earnest tenacity are rarely out of work for long. The chronically unemployed are that way for a reason. They can’t consistently get to work on time. They don’t handle themselves well in the workplace. They can’t avoid run-ins with the law or bouts with substance abuse.

Everyone has problems in their lives that interfere with work - transportation issues, child care needs, etc. - but some people have a problem-solving mindset that allows them to navigate past these problems and still keep a job. Others do not.

To the extent the liberal objection has any merit at all, it will be in a way they won’t like. What it will show is that the incentive to get work in order to maintain Medicaid coverage might be ineffective with many people, but the reason it’s ineffective is precisely because so many of these people chronically maintain poor habits that keep them from being employable in a meaningful sense. It will force society to deal with the fact that many of those we call “the poor” are only poor because of themselves.


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Big-government beneficence

Much of this is caused by generational poverty, to be sure, and that’s an issue that needs to be addressed. People maintain poor habits and a poor outlook on life because everyone around them their entire lives has done the same, so it’s learned behavior. I would be sympathetic to the idea that it’s not your fault that you do what you’ve always been taught to do.

But it still remains true that your problems are the product of your own actions, and more importantly the way you think. There’s something empowering in that truth, because it gives the lie to the liberal idea that the system is rigged against you and there’s nothing you can do to change your lot in life. Of course there is. You can reject the way you’ve been taught to think and act, and learn to think and act in new ways. You’re a human being. As long as you’re capable of learning and willing to do so, you don’t have to be stuck with where you are today.

Then again, if the poor learn to stop thinking with the poverty mindset, there won’t be as much need for big-government beneficence. I’d venture to guess that’s the real reason the left prefers the status quo.

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Dan Calabrese -- Bio and Archives | Comments

Dan Calabrese’s column is distributed by HermanCain.com, which can be found at HermanCain.com

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