Opinion - Working for welfare benefits is not punishment
Conservatives see the requirement as a way to reduce costs; liberals see it as punishment for being poor. But its real benefit is to help individuals regain the dignity and self-respect that comes from having a job.
The Republicans' budget bill will reportedly require states to enforce a work requirement for able-bodied individuals on Medicaid between the ages of 19 and 64. (They can also satisfy the requirement by looking for work or receiving job training.) Exceptions are made for those who are disabled, pregnant women, incarcerated or in a rehabilitation program.
Like the Supplemental Nutritional Assistance Program (also known as food stamps), Medicaid is a means-tested welfare program. Under the bill, an estimated 5 million people are expected to lose their Medicaid coverage, saving the government an estimated $300 billion over seven years.
Any time Republicans propose a work requirement for welfare benefits, liberals and progressives whine and moan and claim the heartless Republicans are trying to punish people just for being poor. For example, the left-leaning Center for Budget and Policy Priorities complains, 'Taking assistance away from people who don't show they are complying with a work requirement punishes them for the racial and gender inequities of our nation's labor market.'
When the Biden administration removed Republican-led work requirements for Medicaid, the pro-labor group On Labor wrote, 'This welcome change is a recognition of the fact that work requirements unfairly punish people living in poverty and are out of sync with workers' needs in the modern economy.'
But it cannot be emphasized strongly enough: Requiring able-bodied people to work for their taxpayer-funded benefits — whether its food, housing, Medicaid or any other means-tested assistance program — is not punishment.
About 165 million Americans under age 65 and their dependents — about 60 percent of the population — currently have employer-provided health insurance. They work for their health insurance. It is a benefit, not a punishment.
When the pandemic started in February 2020, there were 71.4 million people enrolled in Medicaid and the Children's Health Insurance Plan. Due to the Biden administration's Medicaid expansion, that number went up, peaking at 94.6 million in April 2023. Since then, the numbers have slowly declined to 78.5 million. So even if the work requirement reduced the number of Medicaid participants by an estimated 5 million, that's still 2 million more people than were in the program at the beginning of the pandemic.
In short, the proposal does not at all obliterate Medicaid.
But any time a work requirement is proposed on any means-tested welfare program, liberals claim there is no need for it, because most recipients are already working. For example, the Kaiser Family Foundation says that in 2023, 64 percent of Medicaid participants were working full or part-time, and the rest weren't working because they fell into one of the exemptions.
But this misses the point. If able-bodied recipients are already working, then why complain about requiring them to work to receive Medicaid?
Perhaps most hypocritically, liberals and progressives often claim that even if a work requirement increases employment, it doesn't last long. What they don't tell you is that liberal politicians and bureaucrats at all levels of government work relentlessly to reduce, moderate or water down imposed work requirements over time.
Progressives think they are doing welfare recipients a favor, but they're not. People who have been out of the workforce for months or even years begin to lose needed work habits and skills. They begin to lose respect for themselves, and they may turn to alcohol or drugs or other ways to ease the pain.
Some welfare reform groups have demonstrated that employers are willing to take a chance on these individuals, if the state will let the welfare benefits (including Medicaid) continue during a trial working period, offsetting part of the cost to the employer. The employer gets a partially subsidized employee for a limited time, and potentially a full-time employee if it works out.
I have talked to some of these individuals who were required to work for their benefits. They have very encouraging stories to tell of how they regained their dignity by once again providing for themselves and their families. They discover that work is empowering. They just needed a little push to get started.
Merrill Matthews is a public policy and political analyst and the co-author of 'On the Edge: America Faces the Entitlements Cliff.'
Copyright 2025 Nexstar Media, Inc. All rights reserved. This material may not be published, broadcast, rewritten, or redistributed.
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