Brent Merritt is a communications consultant at Metric Communications, focused on health care and medical research.

The debate over Virginia’s Medicaid work requirements has heated back up as Gov. Ralph Northam (D) and Republican legislative leaders butt heads over funding job-search services included in the original Medicaid expansion compromise. Meanwhile, a new analysis suggests that implementing work requirements could kick as many as 74,000 Virginians off the program’s rolls. Beyond the policy implications, I can attest from personal experience that the prospect of losing coverage because of these restrictions is terrifying.

In 2018, I faced complex medical issues that curtailed my ability to work and reduced my earnings. When Medicaid expansion passed last year, I was thrilled to learn that my income at the time would make me eligible for the program. Then I was alarmed to discover that I couldn’t meet Republican legislators’ requirement for hours worked per month and that my condition might not qualify me for a disability waiver. Had my health not improved, I likely would have ended up locked out of my best and perhaps only health coverage option.

While convalescing, I had ample time to reflect on why our Republican representatives seem so uncomfortable providing help to the people who need it most. In the case of work requirements, they claim their objectives are to encourage financial independence and to prevent able-bodied deadbeats from abusing the system. As Sen. Frank W. Wagner (R-Virginia Beach) stated, the requirements target people “who could be working and choose not to. . . . I shouldn’t ask other people out there to pay for their lifestyle.”

This reasoning suffers from two flaws. The first is that threatening people’s access to vital social support programs doesn’t help them find steady work. Research indicates previous welfare work requirements for the Temporary Assistance for Needy Families program sanctioned vulnerable participants but didn’t improve long-term employment outcomes.

The second problem with this logic is that trying to live on a low income in the United States is a brutally difficult experience. The idea that otherwise-able people choose not to work so they can luxuriate in this country’s haphazard-at-best social safety net is ludicrous.

Beyond such barely plausible justifications, where might this apparent obsession with work and disdain toward the less fortunate come from? There’s a compelling explanation that harks back to the nation’s original colonial workaholics. These conservative viewpoints sound eerily similar to the Calvinist religious values that Puritan settlers brought to America, which by many accounts continue to influence morality in our country.

Max Weber, in his quintessential treatise on Calvinist theology and capitalism, “The Protestant Ethic and the Spirit of Capitalism,” explains that the Puritans’ religious doctrine and social code were shaped by their core belief in predestination. In their view, an individual’s ultimate salvation or damnation was predetermined by God, and there was nothing anyone could do to change it. Despite this immutability, and contrary to John Calvin’s instruction on the matter, Puritans looked for outward signs of who was among the favored elect.

According to Weber, “tireless labor in a calling” was the key indicator of an individual’s state of grace. Conversely, “unwillingness to work” and “idleness” were signs of spiritual inferiority. Puritans also expected the elect would be blessed with material success on Earth, so the accretion of wealth was viewed as a sign of God’s favor.

As a result of these beliefs, there wasn’t much room in Puritan society for empathy for people who, for whatever reason, were less productive or not as well off. In fact, because more fortunate members of society were certain of their spiritual superiority, the proper attitude toward their less fortunate, and therefore supposedly sinful, neighbors was “hatred and contempt for them as enemies of God.”

This attitude didn’t encourage acts of mutual social support. Puritans viewed fulfilling their duties to God as their only charitable commitment and felt no particular obligation to provide for the well-being of other people. In this system, Weber observed, “The ‘humanity’ of relationships to one’s ‘neighbor’ is, so to speak, dead.”

I find it oddly comforting that our Republican legislators’ views on who deserves assistance might be informed by our shared Puritan moral heritage rather than simply a wanton disregard for people who are struggling. Nevertheless, you wouldn’t know the difference from their policies.

Puritan theology may have created fertile ground for capitalist economic success, as Weber claimed, but atavistic moralizing about labor, wealth and intrinsic individual worth is a terrible basis for shaping our modern health-care system. We should ensure that everyone in Virginia has unrestricted access to high-quality health-care coverage that is not based on his or her economic output because we recognize the equal human value of every person in our community.

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