Medicaid requirements in Trump's spending bill will hurt those who need it most. This is the method. – Retirement Research Center

Getting people to work may not be the point.

Usually, I don't trust any major legislation that has any major legislation, whose title does not actually have information about its content. So when I see Republicans in the House pass the “a big bill bill” thing, I’m suspicious. I mean, give me something. Like many people, one of the things that caught my attention from Medicaid and the strict work requirements imposed on many recipients when I started to look at what the bill actually contained.

Starting in 2026, the bill will require states to deny coverage of most people aged 19 to 64 who cannot record that they are working or engaging in another qualified activity (for example, volunteering) for 80 hours. Of course I recognize the motivation for job requirements. Most requirements-based programs have built-in suppression work. After all, if you make too much money, you will lose coverage. Well-designed job requirements can be addressed by pairing program receipts with employment. So when I read the bill, I wonder: Does this job require that work be (pun)? I was particularly curious because a retired researcher I cared about (people 50 and older) seemed to be affected and particularly likely to be affected. After all, they are disproportionately relying on the ACA Medicaid expansion targeted by the bill.

In an ideal world, the requirement for Medicaid jobs will encourage people in the program to accumulate work experience, see salary increases, and eventually move to jobs that provide salary and benefits, eliminating the need for Medicaid. Such success depends on two assumptions. First, people who Medicaid are not working now able Work in the future. Second, if these people do work, the job they get will actually lift them out of the need for Medicaid.

On the first point, the fact is that most Medicaid workers can work are working. According to Kaiser Family Foundation, nearly 60% of adult Medicaid recipients are already working. Among the data that are not available, their data suggests that health restrictions are a major limiting factor. The data from Rodlescia Sneed’s team is an idea that intrigued my research for a group of workers I’m interested in. Their study shows that people in this age group work less than 20 hours a week on average for 2.9 chronic health conditions, compared with 1.5 for those who work 20 hours or more. Nearly one-third of these older people who work less than 20 hours are restricted in their daily lives such as diet and beauty.

Therefore, for many of these people, working may not be an option. Now, the bill is said to have exempted people with disabilities from job requirements. However, due to their low income and health problems, many of them do not use computers, the Internet or email. Therefore, getting a waiver will be very challenging, and the risk is that many people who are eligible for the waiver are not exempted.

OK, but what about those who can work on Medicaid but it doesn’t work? Will job requirements lead to higher wages and benefits? Probably not. This question is one of the simple choices. There is a reason why people who are Medicaid and don’t work don’t have jobs – their job prospects may not be good. To see this fact, just look at the Medicaid people yes On-the-job. Figure 1 shows that their financial distress rates are very similar to those of no-work counterparts. Reason: They work in low-paying jobs in small companies and rarely bring benefits.

OK, so most Medicaid recipients already work. Those who don’t work often limit health issues, especially when they retire. And, even if these people do find a job, they are likely to find it in a job with little financial security. There are poor requirements for these jobs. So, it is not surprising that research on a few states trying these requirements is frustrating. The most prominent example is Arkansas, which applies its job requirements to workers aged 30-49 only. Before the court strike, a team of researchers led by Benjamin Sommers found that this had no impact on employment. However, 18,000 people did lose Medicaid coverage. Among them, most people delay medical treatment or prescription due to loss of insurance. Maybe that's the point – cutting Medicaid under the guise of job requirements. You can also explain a bill passed by Congress that has previously found that Medicaid job requirements do not increase employment, but save money by limiting benefits income.

Now, I understand why they participated in a “a large bill bill.” Its ring is better than “harm people who may have difficulty finding work behavior.” ”