Ex-Brown staffer: Medicaid work rule a better deal
Josh Archambault, senior fellow at the Foundation for Government Accountability and former staffer for former Bay State U.S. Sen. Scott Brown, joined Boston Herald Radio’s “Morning Meeting” program to talk about the Trump administration’s decision to allow states to impose work requirements for Medicaid.
Q: This guidance that was given out by the Trump administration was actually requested by states like New Hampshire and Maine. What does this mean?
A: In states that actually administer the Medicaid program — as a reminder, it’s typically been a program for low-income, the elderly, pregnant women and children — it has been expanded under Obamacare, or the ACA, to include a lot of ablebodied adults — like 18to 49-year-olds with no disabilities. A lot of states were looking at their programs as they continue to balloon in enrollment. In Massachusetts, we’re talking about almost 2 million people on the Medicaid program.
So, states around us like New Hampshire and Maine, along with a number of others around the country, said, “We need to figure out a way to get these able-bodied adults back into the workforce,” and if they meet this basic requirement of working, volunteering or training, then they can stay on the Medicaid program.
But the hope is that if you get them engaged in the labor market, they will no longer need your program because they will be making more money and will have access to private health insurance instead.
Q: Gov. Charlie Baker has gone on the record saying that he’s not going to be seeking this out. But he has at one point felt the need to make some changes to health care in general. With nearly 2 million people here in Massachusetts, it’s grown into a $16 billion program, which basically eats up 40 percent of our state budget.
A: It comes down to a question of what is success. Is it having somebody be on Medicaid or is it having them be able to be self-sustainable and have more options? I think it’s a missed opportunity if the governor’s not looking at this . ... Welfare reform in the 1990s had work requirements and it was, broadly speaking, a success in getting people out of poverty.
The question is, can we apply similar principles to the Medicaid program, to a very similar population, that able-bodied adult population. We’re going to find out really quickly if it’s successful. And given the research that I’ve been part of and have seen in other states.
I think that it is going to be successful because if people get reconnected to their community, if they’re able to work, then they’re actually able to make money and have choices instead of being stuck on some of these programs.