For Medicaid recipients, ‘work’ is not a four-letter word

With the application of work requirements for Medicaid recipients recently announced, no longer does our federal government proclaim work to be a four letter word. Kentucky is the first state to come out in support of the work requirements, and I expect we’ll see positive results.

Required in the welfare reform of 1996, able-bodied recipients were expected to go to work if there was a job. This had the remarkable effect of turning around the decade’s old increase in welfare rolls and resulted in a nearly 60 percent reduction nationwide in their numbers. These policies were weakened under the Obama administration. But the Trump administration, in a stunning reversal, is allowing states to implement work requirements. The left is apoplectic.

{mosads}Not since we were involved with Newt Gingrich and President Clinton in welfare reform do our ideas about work for dependent people resonate so strongly with an administration. When Speaker Paul Ryan visited our company, America Works, in Milwaukee last year, he told me there would be a push for work requirements in many of the federal welfare programs. Medicaid now, but more to come. Even if Congress stalls on entitlement reform, there are many more laws on the books that can be strengthened and applied to reform welfare. For example, work requirements for food stamps.

To be clear, we are not suggesting poorhouse policies nor some kind of indentured servitude. Work requirements are only for able-bodied recipients of public support. In the 90s, it was called reciprocal responsibility-get something-give something, or as President Kennedy said “Ask not what your country can do for you, ask what you can do for your country.” A noble and patriotic ideal, but one rejected by many professing compassion.

We at America Works (the first for-profit, welfare-to-work company successfully placing more than 1 million people into jobs) are one trick ponies. We believe work is the answer to poverty, and indeed the poverty rate for full-time employees is only 4.1 percent (compared with 13.5 percent of part-time workers).

We believe in the redemptive value of work. We believe that work gives meaning and is the most powerful acculturating institution we have. We believe, and research confirms, that work reduces medical and mental illness. Pope John Paul ll said it best in a 1981 encyclical: “The whole person, body and spirit, participates in (work), whether it is manual or intellectual work.” Thus, to deny a man work is to deny him part of his spirituality.

So why would some object to work requirements?  

One only has to scan the contrarian press to find out. There, the relationship between working and improved health is unproven. A recent piece in “The Upshot,” for instance, quotes a Centers for Medicare and Medicaid Services report that says “unemployment is generally harmful to health including higher mortality; poorer general health; and higher medical consultation and hospital admission rates.” But the reporter counters, “it is not at all clear how much work or income alone improve health.”  

Now you might be a bit confused by this logic. Let me clarify it for you. Liberal thought is that work, when it comes to a quid-pro-quo for government largesse, is a four-letter word. 

Most arguments against work requirements rest on dubious financial analysis but omit the psychological and societal benefits that come along with a job. Having worked for more than 50 years designing, operating and researching poverty programs, it is unquestionable that work is the best solution to poverty. And it gives meaning to one’s life. More so, work is as primal a drive as need for food, water and sex. Any way society can help provide access to a job must be encouraged. If making it a requirement for government aid, and the person is able bodied, it is imperative that it be supported. It is not mean, it is decent.

It is important that we separately consider the many people who are sick and vulnerable. It is imperative and humane that the process of determining who is eligible be fair and executed with great discretion.

Last example. At America Works, we have been placing people on disability, coming to us voluntarily, into jobs. More than 2,000 people have gone to work and are off disability payments.  Their engagement and delight to be out working is infectious. But how could the government create work requirements for these people and be humane? First, everyone on disability would be reassessed for work readiness by medical and vocational professionals. Then only those so deemed ready would be assigned to go to work if a job was available.

It is time for this country to adopt work as the responsibility of its citizens and recognize that it is an antidote to poverty, ill health and dependence, not a burden to be avoided. It worked for welfare recipients; let’s expand it to others.

Peter Cove is the author of ”Poor No More” and the founder of America Works and The Work First Foundation.