Health Care

Trump’s Latest Attack on Medicaid: Work Requirements


TrumpCare would have destroyed Medicaid as we know it by ending its successful expansion and, for the first time, permanently transforming it into a cap system. Thankfully, we defeated TrumpCare last summer, but Trump isn’t done coming for Medicaid yet. He’s back with a sneak attack in partnership with Republican governors: conditioning Medicaid eligibility on work requirements. Tell your governor and Member of Congress (MoC) not to line up with Trump to take health care away from people relying on Medicaid.

What Trump did

In January, the Trump Administration sent a letter to state Medicaid Directors letting them know that the Administration supports the addition of work requirements as a condition of Medicaid eligibility. They characterized this as a “demonstration project” -- but there is no experimental value in imposing this new barrier to Medicaid eligibility. It does not further Medicaid’s objectives.

Work requirements don’t work

Proponents of work requirements in Medicaid say they are needed to prevent dependency on government aid. This makes no sense. Eight in ten adults on Medicaid already work.  And of those who don’t work, most report disabilities and illnesses preventing them from doing so.

The impact on low-income populations, many who work in seasonal and temporary jobs, of losing their healthcare because they were out of work for a month, will be devastating.  If you want to encourage people to work, taking away their ability to get and stay healthy is not helpful.

Work requirements simply do not work. They already exist in the SNAP (food stamps) and TANF (cash welfare) programs, and for many, they have meant hardship. Also, studies have shown that they have done little to decrease poverty.

And to top it off, the Trump administration is now being sued. Fifteen Kentuckians enrolled in Medicaid filed a class action lawsuit, challenging the Kentucky waiver as inconsistent with the objectives of the Medicaid Act.

Up first: Kentucky

Kentucky is the first state to get approval from the federal government to add work requirements to Medicaid. Proving himself to be totally heartless, Kentucky’s Governor, Matt Bevin, has threatened to end the state’s expansion of Medicaid if his and Trump’s plan to demean Medicaid recipients is proven to be unlawful.  Bevin’s ultimatum means that, if his Administration is caught doing something illegal, then he will rip health care away from nearly 462,000 Kentuckians who have done nothing wrong.

Up next: Mississippi

Mississippi has proposed adding a work requirement as a condition of eligibility for Medicaid. Mississippi already has one of the lowest income eligibility limits for parents in the country at 27 percent of the poverty level (or $5,540.40 per year for a family of three), ranking 48th in the nation.  Under Governor Phil Bryant’s heartless proposal, the Mississippi Department of Medicaid estimates that, after applying all exemptions, about 15,000-20,000 individuals would be required to work.

What You Can Do: Call your governor

While the Trump administration has said it will approve work requirements, your governors decide to submit them. Governors must come out and say they will not ask for a work requirement. If you’re in one of the ten states that have already made the request, your governor must be held accountable for arbitrarily punishing your state’s citizens.

Call script for governor in a state not yet requesting work requirements

Caller: Hello, I’m calling because I’m extremely concerned that the Trump administration is allowing states to create work requirements in Medicaid. I hope Governor ____ would never apply for such a punitive policy.

Staffer:  Thank you for your call. Governor ___ has not taken a position on work requirements in Medicaid.

Caller: Well, they should make a statement making it clear that our state will never try and punish poor people by taking away their health care. Trump is trying to make it harder to be poor and we need to stand up in opposition to his schemes.

Staffer: Thank you for your comments.

Caller: Thank you. I will be following up to ensure the governor speaks out on this issue.

Script for governor in a state already requesting work requirements

Caller: Hello, I’m calling to oppose our state’s proposal to force Medicaid recipients, most of whom already do work or face serious barriers to employment, off of health care if they can’t find a job.

Staffer: Thank you for calling, but this is a policy the governor believes will reduce unemployment/poverty/dependency on the government and we now have permission from the federal government to do so.

Caller: No, work requirements in Medicaid will only increase poverty and make it harder for those who want to find jobs to stay healthy enough to do so. Our state needs to drop this harmful proposal and focus on how to improve health and our economy by empowering, not punishing, those with lower-incomes.

Staffer: Actually, there are plenty of exemptions if people can’t find jobs. They can use volunteer hours as an alternative and if they’re determined to be disabled, it won’t apply.

Caller: How is someone supposed to find a job if they’re spending all their free time providing free labor? And I’m surprised you trust the government to accurately determine who is, and isn’t, too sick to work. These exemptions just sound complicated and unworkable, and won’t fix the problems with Medicaid work requirements.

Staffer: Thank you for your comments, I will pass them on.

Caller: Thank you, I will continue to follow up to oppose implementing these burdensome requirements.

What You Can Do: Call your Members of Congress

Some MoCs are fighting back against Trump’s attack on Medicaid. On January 17, 2018, 29 senators sent a letter to the Acting Secretary of the Department of Health and Human Services, Eric Hargan, expressing concern over Medicaid work requirements. Call your MoC today and ask them to oppose work requirements in Medicaid. If your senator has publicly opposed Medicaid work requirements, please call and thank them, and ask them to remain vocal in their opposition.

Call script for MOC who has not publicly opposed Medicaid work requirements

Caller: Hello, I’m calling because I’m extremely concerned that the Trump administration is allowing states to create work requirements in Medicaid. Does [Congressman / Senator] ___ support such a punitive policy?

Staffer:  Thank you for your call. [Congressman / Senator] ___has not taken a position on work requirements in Medicaid.

Caller: That’s not good enough. [Congressman / Senator] ___ should make a statement opposing work requirements that punish poor people by taking away their health care. Trump is trying to make it harder to be poor and we need to stand up in opposition to his schemes.

Staffer: Thank you for your comments.

Caller: Thank you. I will be following up to ensure the [Congressman / Senator] ___ speaks out on this issue.

Script for MOC who has already publicly opposed work requirements

Caller: Hello, I’m calling because I’m extremely concerned that the Trump administration is allowing states to create work requirements in Medicaid. Does [Congressman / Senator] ___ support such a punitive policy?

Staffer: [Congressman / Senator] ___ opposes Medicaid work requirements.

Caller: That’s great. Could you please ask [Congressman / Senator] ___ to continue to vocally and publicly oppose policies that punish those with lower-incomes?

Staffer: Thank you for your comments, I will pass them on.

Caller: Yes please do, and please take down my contact information so you can let me know what the [Congressman / Senator] ___ decides to do to publicly oppose Medicaid work requirements in future.