Medicaid recipients easy targets for GOP lawmakers

The Medicaid work requirement in the budget bill recently passed by a Republican majority in House of Representatives brings to light political expediency, that is, when you have to make cuts, choose an easy target.

The work requirement is based on a sentiment that goes back years. Former Congressional Budget Office director, Douglas Holtz-Eakin, wrote in 2016 that poverty exists because of “insufficient ability and opportunity to work. A truly self-sufficient individual is the best insurance against poverty.”

Hard to argue that work is crucial. But is lack of appetite for work the problem? It depends on who you ask. Forty-four percent of people who do not receive government assistance—like Republican members of Congress—attribute poverty to poor life choices, while 41 percent of people who receive assistance attribute lack of job opportunities to their poverty.

Speaker of the House Mike Johnson wants the work requirement so “you don’t have able-bodied young men on a program that’s designed for single mothers and the elderly and disabled.” He sees too many men “who need to be out working instead of playing videogames all day.” Really?

According to the Kaiser Family Foundation, roughly 64 percent of Medicaid recipients work full or part time, 29 percent do not work because of school attendance, illness or disability or because they are caregivers, and eight percent are either retired, unable to find work or unemployed for other reasons. Based on these numbers, Republicans must think the existing work exemptions are not tight enough.

Another question: do 71 million Americans qualify for Medicaid because they’re not working or because they’re working at low-paying jobs? A 2018 study by the Center on Budget and Policy Priorities shows that the most common occupations reported by recipients of  Supplemental Nutrition Assistance Program (formerly known as food stamps) and Medicaid are low income jobs—nursing aides, orderlies and attendants, cashiers, cooks and retail sales clerks.

In 2023, Columbus workers in these categories earned between $28,240 and $31,100 annually and comprised 8.9 percent of all workers. That year, the poverty level for a family of four was $30,100. To afford a two bedroom apartment that rented for $1082 a month—the average rent was $1350—and all related utilities, without spending more than 30 percent of one’s income on rent, required hourly pay of $25 or roughly $52,000.

Johnson also justifies the work requirement on grounds that “Medicaid is hugely problematic because it’s plagued by fraud, waste and abuse.” Show me a system where humans are involved, and I’ll show you fraud, waste and abuse, but Medicaid recipients are not the problem.

According to the Georgetown University McCourt School of Public Policy, there are no reliable estimates of the amount of Medicaid fraud, but, based on annual reports from the Departments of Justice and Health and Human Services, we know who the bad actors are.

The December 2024 report lists examples of frauds perpetrated against Medicaid and Medicare. Among those convicted were ambulance providers, medical equipment suppliers, labs, nursing homes, physicians, etc., but—big surprise here for Republicans—no Medicaid recipients.

Here’s what’s really going on. To pass the President Trump’s budget, the House had to find programs it could cut, but cutting programs takes courage, a commodity in short supply among politicians. If you have to cut, then you cut where there will be little outcry and political cost. Low-income people fit the bill.

Pontificating about men playing video games and about fraud, waste and abuse costs a politician nothing. Sure, research groups, doctors and opinions writers will decry what the House has done, but so what? The people affected don’t matter. As income goes down, so does voting. And people of low income don’t make campaign contributions.

You have to love irony. Every member of the House of Representatives has a job, but how many on either side of the aisle actually work?

[This post was published in The Columbus Dispatch on June 27, 2025.}

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Jack D’Aurora writes for Considerthisbyjd.com

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