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But will they?

Trump to states: For the first time, you can impose work requirements on Medicaid recipients

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By —— Bio and Archives January 12, 2018

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Trump to states: For the first time, you can impose work requirements on Medicaid recipients
It’s long been part of populist conservative thinking that welfare recipients should be made to work in exchange for their benefits. It’s largely based on the not-entirely-true assumption that people on welfare are simply refusing to work, rather than failing to find it or keep it for all kinds of reasons you can’t fix simply by changing incentives. Anyway, it’s one of those “damn straight” type ideas that politicians often say they believe, but never actually do because it’s not that simple, or because there’s too much resistance, or . . . well, or because they never really intended to do it in the first place.

In case you haven’t been paying attention, one of the reasons Donald Trump upsets the political class is that when he talks about doing such things, he has a tendency to actually do them. He really pulled out of the Paris Accords. He really recognized Jerusalem as the capital of Israel. So is he really going to make welfare recipients work?

Well, not exactly. But what he has done is issue new federal guidelines that permit states to impose work requirements for Medicaid, which is of course the federally funded and state-administered program of health insurance for the poor:

The Trump administration issued guidelines Thursday to help states impose the first-ever work requirements on Medicaid beneficiaries, one of the biggest changes in the program’s 50-year history.

That approach contrasts with a move the administration made with less fanfare earlier in the week to extend waivers that allow food-stamp recipients in 33 states to avoid work requirements.

The different approaches reflect the complex political forces that surround safety-net programs. Many conservatives argue that people shouldn’t receive government aid without working if they can, but officials in some states want to spare their residents such requirements.

The new work guidelines issued by the Centers for Medicare and Medicaid Services aim to transform Medicaid, in states seeking a program revamp, from a guaranteed benefit based on income to a program that can deny aid to many adults if certain conditions aren’t met. States can determine what can qualify as work under the requirements, such as education or community service.

“This is in response to proposals we are receiving from states,” said Seema Verma, who heads CMS. “This effort is about helping people rise out of poverty.”

Trump Admininstration isn’t forcing any states to impose work requirements

There is only one way to get out of poverty, and that’s to change your behavior - which starts by changing the way you think about your life and how you’ll get what you need to live. From there we get into changed habits and all sorts of other things. Imposing a work requirement as a condition for people to receive public health insurance support could be the sparks that lights a fire and gets someone to decide to make those changes.

But people rarely make them because someone else forced them to. They have to want to make them. Those who don’t will complain long and loud about the work requirements and offer all kinds of reasons they can’t possibly be expected to meet them. And chances are there will be lots of flexibility found in the rules to ensure people who can’t or won’t work nevertheless get access to health care.

But if states want to do this, there is no reason the federal government should tell them they can’t. And the Trump Admininstration isn’t forcing any states to impose work requirements. They’re only giving states the option. If state officials think that’s going to help move people out of poverty, they don’t need Washington telling them otherwise.

Dan Calabrese -- Bio and Archives | Comments

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

A new edition of Dan’s book “Powers and Principalities” is now available in hard copy and e-book editions. Follow all of Dan’s work, including his series of Christian spiritual warfare novels, by liking his page on Facebook.