Democrats, let Medicaid work rules ride until you’ve got that seat
Democrats would be crazy to take the bait offered by the Trump administration last week, with proposed rules requiring so-called able-bodied adults to work or “engage” with their community in order to receive government-sponsored health insurance for poor people.
The announcement that the feds will entertain “demonstration projects” like the one put forth by the Maine Department of Health and Human Services seeking to impose rules requiring work or some state-crafted equivalent in order to qualify for Medicaid is not worth losing elections over, which is what will happen if the Republican Party succeeds in entrapping empathetic Democratic candidates into a debate about America’s work ethic. The solution to bad, ineffective Republican-sponsored policies that nevertheless resonate in the culture war is to get elected and craft better policies.
This is not to say that I buy what President Trump and Republicans are selling – namely, that poor people can’t be trusted with health insurance. The theory that tens of thousands of people in Maine, for instance, are “able-bodied” but nevertheless so feeble-minded as to lack the ambition or too lazy to dream of a meaningful job or desire cash in their wallet, oil in their tank and food in their fridge without the prodding of Uncle Sam and a chokehold of bureaucratic red tape is like saying businesses in Maine wouldn’t seek a profit but for Pine Tree Development Zones.
Do Republicans actually believe there is a great swath of men and women who choose poverty to get health insurance and only a mandate by the government will get them off the proverbial couch? Who knows – but the narrative matches nicely with all the other finger pointing at vulnerable groups – immigrants, minorities – when an economy rigged for rich people is leaving so many behind. The Republican position that government – when it’s Obamacare – can’t mandate the purchase of health insurance (give me liberty!) but “conservative” government can mandate a show of paperwork proving your dignity is not intellectually defensible – and can we talk about the bureaucrat whose taxpayer-funded job it will be under Maine’s demonstration project to decide which able-bodied poor people deserve government-sponsored health insurance?
Maine under the LePage administration seeks to create a government program to police another government program in the name of smaller government when their track record of protecting the “truly needy” is dismal. The proportion of children living in deep poverty in Maine increased at eight times the national average – faster than in any other state – between 2011 and 2015.
The number of people who will be affected by a new work requirement rule for Medicaid is not big in context – the entire category of able-bodied is small to begin with, and most of them are off the couch. According to the Kaiser Family Foundation, of the 100,000 or so of these people, 64 percent are already working – so we are talking about 36,000 people who might be “incentivized” to work or volunteer under the new rule. This small group – especially if they are, in fact, the scapegoats – will benefit far more if Democrats are elected than if Democrats die on the sword standing on their principles in campaign debates about work.
It’s instinctively fair to ask those who get government benefits to chip in and do their part. At common law there is a duty to mitigate one’s damages. The issue at heart, though, is bias against the poor.
Maine doesn’t ask corporations, for instance, who reap great economic reward at taxpayer expense from the Pine Tree zones to demonstrate they have lifted a finger to create a single job in order to qualify for benefits of a program designed to create jobs. A recent report by Maine’s state government watchdog agency found virtually no accountability for a corporate welfare program costing Mainers, all told, about $17 million per year. How about a little incentivizing for these companies with rules about accountability and transparency?
Sometimes fighting for “the principle” of something works in campaigns and sometimes it doesn’t, and arguing against this proposed rule is a loser for candidates. Flag burning may be a civil right protected under the Constitution, but it makes for a lousy bumper sticker. If Democrats make the election about defending government benefits, they lose.
I have this message for candidates running in the Trump era: Resist a knee-jerk reaction to every welfare reform proposal thrown up in the air by Republicans.
Restricting the purchase of junk food with Supplemental Nutrition Assistance Program benefits is a fine idea. I would even venture to suggest that if the people of this country would feel more confident and secure about the democratic process, they would accept being asked to produce proof of citizenship in the case of federal elections and other qualifiers at local elections. Pick your battles, as they say, and winning elections should be on top of any list. Democrats lulled into intellectual debates about abortion – or whether surgery for transgender veterans is as much a right as torching Old Glory – do so at their peril.
There is a reason these are called “hot-button” issues. Flag burning may be legal, but it’s not good.
The proposed Trump/LePage administration work requirement rules may be an illegal usurpation of Congress’ power to make laws. If so, it will be up to the Republican Congress to do the heavy lifting on a complicated health care issue they heretofore have been unable to do. Democratic candidates should leave the legal battle to the public interest organizations taking up that fight.
Government-mandated civic engagement is not an issue worth losing an election over.
As published in the Portland Press Herald