The Washington PostDemocracy Dies in Darkness

Opinion Republicans’ ‘best’ issue on the debt is still horrible

House Speaker Kevin McCarthy (R-Calif.) at the U.S. Capitol on Thursday. (Jabin Botsford/The Washington Post)
5 min

Sober Republicans certainly must know their threat to blow up the economy and cause a default is untenable. They probably know that draconian cuts they propose, which will amount to 22 percent of law enforcement, veterans benefits, health care and the rest of nondefense discretionary spending, won’t endear them to most voters. However, they might be under the illusion that instituting work requirements for food stamps and Medicaid is going to score with working people who resent others getting something for “free.” In fact, it’s rotten policy that will not encourage more people to work.

For starters, Republicans appear to operate under the presumption that most beneficiaries are mostly poor, able-bodied loafers sitting on the couch, grabbing benefits. That’s daft. People who can work need to work to get by. Food stamps — which provide just enough for minimal staples (and not enough for a healthy diet) — or free medication won’t pay for rent, utilities, transportation or clothing. It makes no sense for people to refrain from earning enough to pay for all their daily expenses for the “privilege” of getting nutritionally poor foods or seeing a doctor (rather than visiting the emergency room).

Moreover, data proves that the vast number of recipients are either working poor or wouldn’t be required to work anyway (e.g., people with disabilities, children, seniors in nursing care). The Kaiser Family Foundation found a significant majority of “non-elderly adult Medicaid enrollees who did not qualify based on a disability were already working full- or part-time.” Furthermore, “Most who were not working would likely meet exemptions from work requirement policies (e.g., had an illness or disability or were attending school), leaving just 7% of these enrollees to whom work requirement policies could be directed.”

We have evidence already from the Arkansas Medicaid work requirement experiment over a 10-month period and from experiments briefly in effect for Michigan and New Hampshire. Work rules applied to only 3 to 4 percent of recipients — that’s proof of the mischaracterization of these people as moochers. Of those who were affected, thousands got kicked out of the system not because they were slackers but because they didn’t complete the paperwork.

Many beneficiaries “didn’t know about the work requirement or whether it applied to them,” the Center on Budget and Policy Priorities found. “It’s likely that people with disabilities were particularly at risk.” And those whose work is transitory (a lot one month and little the next) were at risk of going in and out of coverage.

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Moreover, there was no evidence it increased the number of people working. The CBPP found that nearly all of the beneficiaries who met Arkansas’s new requirements “were already working before the rules took effect or because they complied with work requirements already in place under SNAP (formerly food stamps).”

Henry Olsen

counterpointMcCarthy’s debt plan needs an endgame. Here’s what it could look like.

The stick of losing benefits injures the unwary and creates more uninsured people:

A study by Harvard researchers found that the uninsured rate among low-income Arkansans aged 30-49 — the group potentially subject to work requirements — rose from 10.5 percent in 2016 to 14.5 percent in 2018, after the work requirement took effect. There was no similar increase for low-income Arkansans of other ages or for low-income people aged 30-49 in other, similar states. This finding refutes claims, for example from HHS Secretary Alex Azar, that most people leaving Medicaid due to the policy did so because they found jobs with health insurance. …
Beneficiaries already had enough reasons to work: they needed to pay their bills. But they often struggled with unstable work hours, lived in rural areas with few jobs, or faced other barriers to employment — and the state didn’t invest any new money in job training programs, services to address barriers, or supports like transportation to help beneficiaries connect to jobs.

When work requirements are instituted, states such as Arkansas do a rotten job notifying recipients and applicants and explaining the program. The Department of Health and Human Services found that “one year after implementation began, a survey of individuals subject to work requirements found one-third of them had not heard anything about the policy, while 44 percent were unsure whether the policy applied to them.”

Poor people’s health is adversely impacted. A 2021 HHS report found “that adults with chronic conditions in Arkansas were more likely to lose coverage.” Moreover, “50 percent reported serious problems paying off medical bills; 56 percent delayed seeking health care because of cost; and 64 percent delayed taking medications because of cost.” If the aim is to make poor people sicker, it “worked.”

Upon closer examination, we can see Republicans are taking away funds for food and medical coverage for poor people and sending the money to tax cheats. The estimated cost of the “savings” from denying food and health care to the poor is roughly the amount they want to take away from IRS funding that would be used to go after tax cheats (those people who are by definition stealing from the taxpayers). House Republicans say their Medicaid and SNAP cuts save tens of billions; the Congressional Budget Office score shows a $114 billion cost for repealing the IRS enforcement.

Taking a step back, the work requirements are advancing a noxious vision to make the government budget (taxes and spending) more regressive. MAGA Republicans want to keep all the Trump tax cuts and eliminate President Biden’s plan to make corporations pay something and to tax stock buybacks. The things that help poor and middle-class people have either already expired at Republicans’ insistence (e.g., the child tax credit expansion) or have been put on the chopping block (e.g., $35 insulin, drug caps on Medicare, green-energy subsidies, student loans). One doesn’t have to be a “socialist” to think it grotesque to make the rich even richer as a result of cutting benefits to the poor.

As Biden says, show me your budget and I’ll tell you your values. For Republicans, that means making the poor sicker and more food insecure while fattening the wallets of the super rich. Fortunately, little to none of the Republicans’ debt plan will see the light of day.