Latest news with #workrequirements
Wall Street Journal
13 hours ago
- Business
- Wall Street Journal
Medicaid Work Requirements Have Mostly Failed. The GOP Is Still Pushing Them.
Republicans are pushing to add Medicaid work requirements to the budget bill they are moving through Congress, saying the provisions are necessary to cut costs and get more low-income Americans back on the job. State experiments with that approach show its limits.
Forbes
2 days ago
- Health
- Forbes
Five Ways Medicaid Work Requirements Could Harm Small Businesses
Healthcare worker filling in a form with a patient during a home health visit Last month, the U.S. House of Representatives passed a budget reconciliation package that includes hundreds of billions in dollars to cuts in Medicaid that are projected to leave millions of Americans without health insurance. The majority of these cuts will come from more stringent work requirements mandating that Medicaid recipients either work, volunteer, or be enrolled in school for at least 80 hours a month. Legislation proposed in the Senate would expand the requirement to teenagers and make even more cuts to Medicaid. While this is promoted as an effort to eliminate waste, it is important to note that the majority of Americans enrolled in Medicaid are already working. However, if you are an adult in Bradshaw, WV, or New Orleans Ninth Ward and you suddenly lose your job, you cannot immediately enroll in courses at a community college or begin volunteering at a nonprofit. Even on the off-chance that those opportunities are available, it may still be logistically and financially impossible for you to do so. At the state level, Medicaid work requirements have also historically led to unintended disenrollments. For example, Georgia last year denied nearly percent of applicants because they reported less than the required 80 hours per month or did not sufficiently verify their hours. The truth is that Main Streets and communities across the country, especially underserved ones, rely on the stability of the consistent healthcare coverage that Medicaid provides. If these cuts and work requirements go into effect, here are five ways that it could negatively impact small businesses and their employees. 1. Threat to Coverage for Working Low-Income Employees A recent survey of small businesses found that nearly three in five have owners, employees, or family members who rely on Medicaid or CHIP coverage. Many workers in small businesses are already meeting these proposed work requirement thresholds, but their hours fluctuate, especially in the retail and hospitality sectors. Some – including U.S. citizens – may not have proper documentation to verify work, especially gig, cash-based, or shift workers. That being said, even if they are working and their hours dip or they miss a month reporting them, they could still lose coverage. More employees becoming uninsured would ultimately lead to worse health outcomes and higher absenteeism, not only hurting small businesses, but communities as well. 'If Congress cuts funding for Medicaid benefits, Missouri workers and their children will lose their health care. And hospitals will close. It's that simple. And that pattern will be replicated in states across the country,' Senator Josh Hawley [R-MO] 2. Administrative Burdens and Red Tape While there has been so much talk around government efficiency as of late, work requirements can be even more bureaucratic and usually involve complex reporting systems. Many small business workers may not have digital access or face language barriers when missing paperwork or tech errors can result in automatic loss of coverage. This means small businesses may see more turnover or have to step in to assist with compliance even if they do not have the capacity to do so. 3. Reduced Workforce Participation Losing Medicaid could make it harder to stay healthy or afford to work—especially in physically demanding jobs. Because of this, caregivers, older workers, and people with chronic illnesses may find it hard to meet these more rigid work requirements and just choose to stay on Medicaid without working. That same survey found that 43% of small business owners predict higher employee turnover. This will shrink the available labor pool and make it harder for small businesses to hire and retain talent. 4. Increased Costs for Small Businesses When employees lose Medicaid, they may skip needed care and show up sick or not at all. Some workers may ask their employers to step in with health coverage or unexpected healthcare costs, which will either be very expensive or unaffordable, leaving them in a lose-lose situation. Most small business owners are already bracing for this, as the survey found that more than half said they would face new pressure to provide employee healthcare coverage, directly hitting their bottom line. 5. Disproportionate Impact on Rural and Underserved Areas Many businesses in rural areas or marginalized communities rely on Medicaid to keep their staff and customers healthy. The proposed work requirements could strip coverage from people in areas that have less job opportunities, where their only means of transportation is their car. Medicaid work requirements may seem like a way to encourage employment, but in practice, they could harm the very workforce small businesses rely on and disrupt the morale of their communities and local economies. There are a number of legislative steps ahead before these cuts would become law and it would be worth lawmakers time to see how they would truly impact Main Streets in their districts.
Yahoo
2 days ago
- Politics
- Yahoo
SNAP work requirement carveouts for vets, homeless caught in crosshairs of Trump bill
Congress could soon put an end to work requirement exemptions for veterans, homeless individuals and youth that were in foster care who receive food assistance. While House Republicans preserved the exemptions to work requirements under the Supplemental Nutrition Assistance Program (SNAP) as part of their broader package to advance President Trump's tax cut and spending priorities, Senate Republicans omitted the key language in their version of the bill. The exemptions were initially negotiated as part of a bipartisan deal two years ago. The GOP-led Senate Agriculture Committee confirmed the provision's absence would mean the exemptions would no longer be retained for members of the three groups. The move has drawn little attention on both sides of the aisle so far, as other pieces of the Republicans' megabill take center stage, including significant changes to Medicaid and what some estimates have projected as a multitrillion-dollar tax package. Even multiple GOP members of the Senate committee that produced the text say they intend to press for more information about the potential change before the upper chamber votes on the bill. 'When you have an opportunity to restore dignity and hope and belief back to someone, we're doing something that I think is, is our obligation, you know, we should try to help people that are down under luck and having a hard time,' Sen. Jim Justice ( a member of the committee, also told The Hill when asked about the matter. However, he added, 'From the standpoint of the SNAP benefits and everything, if we're doing something that is detrimental to our veterans, shame on us, because they have given us so much it's off the chart.' Senate Agriculture Committee Chair John Boozman (R-Ark.) said Wednesday that 'everybody ought to be treated the same' when asked about the matter. A Senate Republican aide also noted that individuals who aren't 'able-bodied' wouldn't 'have to meet those requirements' under the Senate plan. Congress had previously agreed to temporary changes to work requirements for SNAP in 2023 as part of a bipartisan deal to cap annual federal spending and raise the nation's debt limit. That included measures carving out exemptions through September 2030 for individuals experiencing homelessness, veterans, and young adults who were in foster care at the age of 18. In a statement on the matter last Friday, the Senate committee said Republicans are working 'to encourage greater independence through work and training opportunities.' However, it noted its plan would still allow for 'individuals who are physically or mentally unfit for employment are not required to meet the 20 hours per week work requirement whether in those groups or not.' The decision comes as Republicans in both chambers are working to root out 'waste, fraud and abuse' in what some have described as a 'bloated' government program that has seen its spending climb over the years. Other notable changes Republicans are seeking to make to SNAP include requiring states to cover some of the cost of benefits and front a greater share of administrative costs for the program, as well as limiting the federal government's ability to increase monthly benefits in the future. The Senate Agriculture Committee estimates its plan will yield 'an approximate net savings of $144 billion' in the coming years, with Republicans' proposal requiring states to cover some SNAP benefits costs estimated to account for a significant portion of the projected spending reductions. The plan is part of a larger pursuit by the party to find measures to reduce federal spending by more than a $1 trillion over the next decade that can ride alongside an extension of Trump's 2017 tax cuts and other tax priorities. Democrats have come out in staunch opposition to the evolving proposal that is being exclusively crafted between House and Senate Republicans. 'The Republican bill takes food away from vulnerable veterans, homeless people and young adults who are aging out of the foster care system and may not know where their next meal is coming from,' Rep. Angie Craig (Minn.), top Democrat on the House Agriculture Committee, said in a statement on Wednesday. 'Republicans want to make these cuts to food assistance to fund new tax breaks for people who are already wealthy and large corporations,' she added. Some experts are also sounding the alarm. 'It is a huge deal. These groups were carved out for a reason. They are vulnerable for a reason,' Kyle Ross, a policy analyst for Inclusive Economy at the left-leaning Center for American Progress, said, adding the exemptions apply to 'different populations with their own special set of circumstances.' 'There are an estimated 1.2 million veterans receiving SNAP, and veterans are more likely to live in a food insecure household than nonveterans, so they're really more likely to be in need of some food assistance,' he said, while also pointing to barriers homeless individuals and those aging out of foster care face in the job market. But others have argued against the need for the special carveouts. Angela Rachidi, senior fellow at the right-leaning American Enterprise Institute (AEI), described the 2023 spending caps deal as 'a political compromise,' noting that Republicans had also secured increases to the age threshold for SNAP as part of the deal under the Biden administration. Some hardline conservatives had also been critical of the deal at the time, while pointing to SNAP's exemptions. 'Many states would exempt people anyway because of mental health issues and you don't always necessarily have to have a doctor's note for it,' she said, while also arguing there wasn't 'anything unique about those populations that make them not capable of work.' She added that doing away with the carveouts could help lessen states' burden by removing 'another level of screening.' 'They don't have to assess somebody for their veteran status or foster status, and they would assess them anyway for their shelter status,' she said, while suggesting from a 'bureaucratic perspective, it actually might make it easier.' At the same time, Lauren Bauer, a fellow in Economic Studies at the Brookings Institution, pointed to the added strain states could face if other proposals from Republicans to increase states' cost share of the program's benefits and administrative cost also take effect. 'What the bill also does is, on both sides, you know, reduces the support that the federal government gives to states to administer the program and identifying and validating exemptions, the health exemptions, etc. is very expensive,' Bauer said. 'And administering work requirements is also very, very expensive, because it is onerous not only on the SNAP participant, it's onerous on the state who is managing the program,' she added. Copyright 2025 Nexstar Media, Inc. All rights reserved. This material may not be published, broadcast, rewritten, or redistributed.
CBS News
4 days ago
- Politics
- CBS News
GOP wants people up to age 64 to work for food stamps and Medicaid. Some experts say it won't work.
The Republican's "big beautiful" budget package would add new work requirements for millions of Americans who rely on Medicaid and food stamps. Tying federal aid in exchange for work is "common sense," according to House Speaker Mike Johnson, who said it would encourage people to get jobs. While the food stamp program already has a work requirement, the GOP bill tightens the regulation for beneficiaries, requiring those who are so-called "able-bodied adults without dependents," or ABAWDs, to prove they're working up to age 64, up from the current threshold of 54 years old. Taken together, the new requirements would add reporting requirements for millions of low-income Americans, who would need to prove they're working or else volunteering or enrolled in an educational program to qualify for health care or food assistance. Republican lawmakers say it makes sense to tack on these restrictions to ensure that people aren't "gaming the system," in Johnson's words, while also encouraging them to seek employment. There are millions of people on Medicaid "right now nationwide who are able-bodied workers, young men, for example, who are not working, who are taking advantage of the system," Johnson told CBS News' "Face the Nation" on May 25. "The One, Big, Beautiful Bill's work requirements — which include activities such as volunteering, job training, or looking for a job — are commonsense reforms that are overwhelmingly popular among the American people," a White House official told CBS MoneyWatch. "These reforms will not only address waste, fraud and abuse, but protect and preserve Medicaid for the Americans whom the program was intended to serve as a lifeline for: seniors, disabled individuals, and low income families." About two-thirds of Americans back work requirements for SNAP and Medicaid, according to a 2023 Axios poll. Growing body of research Work requirements were first introduced into the Supplemental Nutrition Assistance Program (SNAP) — the formal name for the food-stamp program — under President Bill Clinton. And two states, Arkansas and Georgia, have in recent years introduced work requirements for Medicaid recipients, although Arkansas dropped its plan after a judge blocked it in 2019. That's allowed economists and policy experts to study work requirements and how they have impacted people who rely on food assistance and public health insurance. So far, there's little evidence to show work requirements boost employment among the low-income Americans who rely on the programs. Instead, some recipients end up losing their benefits after work requirements are introduced due to administrative hurdles of proving employment, failure to find enough work to qualify, or other issues like disability or illness, experts told CBS MoneyWatch. Take a 2019 research paper published by the National Bureau of Economic Research, which examined what happened when Virginia reinstated work requirements for some food stamp recipients in 2013. The researchers found that after work requirements went into effect, SNAP enrollment of people who were subject to the regulation dropped by about 50%. "But it did not lead to any meaningful increase in employment or earnings on average," Adam Leive, an assistant professor at the Goldman School of Public Policy at University of California, Berkeley, and a coauthor of the paper, told CBS MoneyWatch. "And so, what we instead found was that work requirements largely functioned as a way to remove people from the program, but without improving their employment prospects." He added, "Our results probably provide some evidence as to what would be expected in Medicaid." The GOP budget measure passed in the House in May with a one-vote margin, solely with Republican votes. On Tuesday, the Senate Finance Committee unveiled its portion of the bill. While it changes some of the House version's provisions, it continues to include the Medicaid work requirement for adults between 19 to 64 who aren't disabled and don't have children. The Senate Committee on Agriculture, Nutrition and Forestry's portion of the bill, also released Tuesday, maintains the House version's higher age threshold for the food stamp program. Medicaid and work About 18.5 million Medicaid recipients, or roughly 1 in 4 enrollees, would be subject to the new work requirement if the GOP package becomes law, according to a June 4 analysis by the nonpartisan Congressional Budget Office. Of those, roughly 4.8 million people are likely to lose health insurance due to the new policy, it projected. "Research and real-world experience both show that work requirements don't help people find or maintain work," wrote Allie Gardner, a senior policy analyst at the Center for Budget and Policy Priorities, a policy think tank, in a June 12 research report. The new Medicaid work requirements would be particularly stringent, she added. First, the provision would deny coverage to applicants who can't show they're already working, volunteering or enrolled in an educational program for 80 hours a month before they are enrolled. States, which administer Medicaid to their residents, would be permitted to block enrollment to people who can't show they have already had months of work under their belt, she added. States could also require people to verify their employment as frequently as once per month, and require up to six months of consecutive work to keep their Medicaid enrollment, she said. The two states that have sought to introduce work requirements for Medicaid enrollees have had mixed results. In Arkansas, about 18,000 adults lost coverage in the first four months after the policy went into effect, out of the state's roughly 800,000 enrollees. More than half of those reported they delayed medical care and more than 6 in 10 said they delayed taking medications because of cost, according to a 2020 analysis by researchers at Harvard University's T.H. Chan School of Public Health. The requirements didn't boost employment, the researchers also found. Burdensome requirements Georgia is the only state with a current work requirement for Medicaid, offering a program targeted to certain low-income adults who wouldn't otherwise qualify. Like the GOP budget bill's provision, Georgia requires beneficiaries to perform 80 hours a month of work or other activities, such as volunteering or schooling. But that program has cost the state $86 million while enrolling 6,500 people in its first 18 months, far short of enrollment goals, partly because of the administrative burdens of verifying employment as well as technical glitches, Pro Publica has reported. One enrollee, BeShea Terry, 51, told the Associated Press that maintaining her standing in the program has been difficult, including encountering numerous erroneous messages that she hadn't uploaded proof of her work hours. When her coverage was mistakenly canceled in December, it took months of calls to a caseworker and visits to a state office to resolve, she said. "It's a process," she said. "Keep continuing to call because your health is very important." Georgia Gov. Brian Kemp's administration has defended the program as a way to transition people to private health care. At least 1,000 people have left the program and obtained private insurance because their income increased, according to the governor's office. Older Americans at risk Some policy experts are particularly concerned about the bill that would require people up to age 64 to prove they're working in exchange for food aid or health insurance because older Americans can face greater employment struggles due to ageism, health issues or needing to care for an ill spouse or relative. The SNAP program's current work requirement only applies to people up to age 54. If the bill's higher age threshold is enacted, about 1 million Americans between 55 to 64 would be at risk of losing food stamps, according to the CBPP. "It's so much harder at that age to find a job, based on age discrimination, outdated skills and you may have health issues that don't rise up to a full disability," Salaam Bhatti, director of the SNAP program at the Food Research & Action Center, an anti-hunger advocacy group, told CBS MoneyWatch. He added, "What it ultimately does is just remove them from the program that's helping them put food on the table." Some advocacy groups for older Americans are urging lawmakers to rethink hiking SNAP's work requirement to age 64, as well as adding the employment requirement for Medicaid. "We oppose efforts to add new burdens that could cost people their health care coverage not because they are ineligible, but because they missed a deadline or could not navigate a complex system," wrote AARP President Nancy LeaMond in a May 21 letter to Johnson and House Minority Leader Hakeem Jeffries. The higher age limit for SNAP's work requirements "is especially harmful to older adults who often face age discrimination, longer unemployment, chronic health conditions and caregiving responsibilities that limit their ability to stay in the workforce," she added. contributed to this report.
Yahoo
6 days ago
- Health
- Yahoo
The GOP's big bill would bring changes to Medicaid for millions
WASHINGTON (AP) — Republican Sen. Josh Hawley has been clear about his red line as the Senate takes up the GOP's One Big Beautiful Bill Act: no Medicaid cuts. But what, exactly, would be a cut? Hawley and other Republicans acknowledge that the main cost-saving provision in the bill – new work requirements on able-bodied adults who receive health care through the Medicaid program -- would cause millions of people to lose their coverage. All told, estimates are 10.9 million fewer people would have health coverage under the bill's proposed changes to Medicaid and the Affordable Care Act. That includes some 8 million fewer in the Medicaid program, including 5.2 million dropping off because of the new eligibility requirements. 'I know that will reduce the number of people on Medicaid,' Hawley told a small scrum of reporters in the hallways at the Capitol. 'But I'm for that because I want people who are able bodied but not working to work.' Hawley and other Republicans are walking a politically fine line on how to reduce federal spending on Medicaid while also promising to protect a program that serves some 80 million Americans and is popular with the public. As the party pushes ahead on President Donald Trump' s priority package, Republicans insist they are not cutting the vital safety net program but simply rooting out what they call waste, fraud and abuse. Whether that argument lands with voters could go a long way toward determining whether Trump's bill ultimately ends up boosting — or dragging down — Republicans as they campaign for reelection next year. Republicans say that it's wrong to call the reductions in health care coverage 'cuts.' Instead, they've characterized the changes as rules that would purge people who are taking advantage of the system and protect it for the most vulnerable who need it most. What's in the bill House Republicans wrote the bill with instructions to find $880 billion in cuts from programs under the purview of the Energy and Commerce Committee, which has a sprawling jurisdiction that includes Medicaid. In the version of the bill that the House passed on a party-line vote last month, the overall cuts ended up exceeding that number. The Kaiser Family Foundation projects that the bill will result in a $793 billion reduction in spending on Medicaid. Additionally, the House Ways & Means Committee, which handles federal tax policy, imposed a freeze on a health care provider tax that many states impose. Critics say the tax improperly boosts federal Medicaid payments to the states, but supporters like Hawley say it's important funding for rural hospitals. 'What we're doing here is an important and, frankly, heroic thing to preserve the program so that it doesn't become insolvent,' Speaker Mike Johnson said on NBC's 'Meet the Press.' House Democratic leader Hakeem Jeffries, meanwhile, has denounced the bill as an 'assault on the healthcare of the American people' and warned years of progress in reducing the number of uninsured people is at risk. Who would lose health coverage The nonpartisan Congressional Budget Office estimates that the GOP's proposed changes to federal health programs would result in 10.9 million fewer people having health care coverage. Nearly 8 million fewer people would be enrolled in Medicaid by 2034 under the legislation, the CBO found, including 5.2 million people who would lose coverage due to the proposed work requirements. It said 1.4 million immigrants without legal status would lose coverage in state programs. The new Medicaid requirements would apply to nondisabled adults under age 65 who are not caretakers or parents, with some exceptions. The bill passed by the U.S. House stipulates that those eligible would need to work, take classes, or record community service for 80 hours per month. The Kaiser Family Foundation notes that more than 90% of people enrolled in Medicaid already meet those criteria. The legislation also penalizes states that fund health insurance for immigrants who have not confirmed their immigration status, and the CBO expects that those states will stop funding Medicaid for those immigrants altogether. Why Republicans want Medicaid changes Republicans have cited what they call the out-of-control spending in federal programs to explain their rationale for the changes proposed in the legislation. 'What we are trying to do in the One Big Beautiful Bill is ensuring that limited resources are protected for pregnant women, for children, for seniors, for individuals with disabilities,' said Rep. Erin Houchin, R-Ind., in a speech on the House floor. Senate Majority Whip John Barrasso argued that Medicaid recipients who are not working spend their time watching television and playing video games rather than looking for employment. Republicans also criticize the CBO itself, the congressional scorekeeper, questioning whether its projections are accurate. The CBO score for decades has been providing non-partisan analysis of legislation and budgetary matters. Its staff is prohibited from making political contributions and is currently led by a former economic adviser for the George W. Bush administration. What polling shows While Republicans argue that their signature legislation delivers on Trump's 2024 campaign promises, health care isn't one of the president's strongest issues with Americans. Most U.S. adults, 56%, disapproved of how Trump was handling health care policy in CNN polling from March. And according to AP VoteCast, about 6 in 10 voters in the November election said they wanted the government 'more involved' in ensuring that Americans have health care coverage. Only about 2 in 10 wanted the government less involved in this, and about 2 in 10 said its involvement was about right. Half of American adults said they expected the Trump administration's policies to increase their family's health care costs, according to a May poll from KFF, and about 6 in 10 believed those policies would weaken Medicaid. If the federal government significantly reduced Medicaid spending, about 7 in 10 adults said they worried it would negatively impact nursing homes, hospitals, and other health care providers in their community. For Hawley, the 'bottom lines' are omitting provisions that could cause rural hospitals to close and hardworking citizens to lose their benefits. He and other Republicans are especially concerned about the freeze on the providers' tax in the House's legislation that they warn could hurt rural hospitals. 'Medicaid benefits for people who are working or who are otherwise qualified,' Hawley said. 'I do not want to see them cut.'
