The big news Thursday morning — besides President Trump undercutting his own White House on FISA — was that his administration is moving to allow states to impose work requirements on Medicaid recipients. And as The Washington Post's Amy Goldstein reports, it's a legally controversial decision because it would impose such requirements for the first time in Medicaid's half-century history. It's simply not clear that the law allows for it. And opponents quickly cried foul, arguing that the move would harm the poor.
Politically speaking, though, this is among the least controversial things Trump has done as president. For decades, Americans have overwhelmingly supported work requirements for government assistance.
A poll from the Kaiser Family Foundation in June showed that fully 70 percent of Americans favored allowing states to impose work requirements on non-disabled adults receiving Medicaid, which is basically what the Trump administration is doing. Ten states have signaled that they would like to impose such requirements, while three others are considering them.
The change was the most popular among potential changes to Medicaid, including requiring beneficiaries to undergo drug tests (64 percent).
The proposal was more popular with Republicans, among whom 82 percent supported it. But even 56 percent of Democrats were in support. And independents were overwhelmingly in favor, with 77 percent supporting it.
A September poll from Politico and the Harvard T.H. Chan School of Public Health had almost identical overall numbers, with 72 percent of Americans in favor of “requiring low-income, able-bodied adults without young children to work in order to receive Medicaid benefits.” Just 24 percent were opposed.
Similar requirements have already been imposed on recipients of welfare and food stamps, though the Obama administration in 2012 gave states more flexibility on welfare's work requirement. That requirement was initially part of the Clinton administration's welfare reform efforts in the mid-1990s, and it was overwhelmingly popular at the time, with a Washington Post-ABC News poll showing that 94 percent of Americans supported it. By the time President Barack Obama acted, support was still at 79 percent in a Republican-leaning Resurgent Republic poll.
And as Kaiser's Drew Altman wrote in April, it's unlikely that the change will affect that many Medicaid beneficiaries, because such requirements usually have key exemptions for family care, the disabled and those of retirement age. Only about 1 in 10, per Kaiser's numbers, didn't work and didn't qualify for one of these exemptions. And most of those said they were searching for work, which is another exemption that recipients can generally use — provided it's documented.
Opponents of the move quickly decried the Trump administration's action, arguing that it represented a gutting of Medicaid and the administration's disregard for the poor (which was a big part of the pushback against the failed effort to replace Obamacare). But assuming such exemptions are included in how states implement their changes — and the Department of Health and Human Services is recommending they are, urging states to mirror the work requirements for food stamps — this seems to be something the vast majority of Americans support.
Of course, now that Trump has affixed his name to such a move, that could change in a hurry.