Terry H. Schwadron
May 27, 2018
As we discussed earlier this year, the Trump administration has moved to make it a requirement for food stamp and Medicaid recipients to work or to be recorded as looking for work.
At the time, Seema Verma, administrator of the Centers for Medicare and Medicaid Services, meaningful work is essential to “to “economic self-sufficiency, self-esteem, well-being and . . . health.”
The various states have been moving independently to create these new work requirements, which may end up denying Medicaid coverage to tens of thousands, even hundreds of thousands off the rolls. Obviously, who remains eligible will depend on the rules set by the individual states.
Normally, this is why the federal government generally plays a role in setting a singular standard, though just what the real intentions are here are unclear, at least to me.
So, imagine my reaction as I came upon information in a Washington Post op-ed column by Christine Emba: “In recent months, a number of GOP-controlled states have been quietly crafting waivers that would end up shielding rural, white residents from this new scheme for self-esteem.”
“It seems an unusually transparent move, even for a party that tends toward the blatant in its disdain for those not seen as “real Americans.” But most of all, it’s an example of how much-touted moral policy stances — such as solicitude for the ‘dignity of work,’ or ‘zero tolerance’ for drugs, or ‘extreme’ immigration vetting — often give shelter to less attractive tribal loyalties.’ “
What? Let’s have more work requirements for poorer Americans, but not in states that vote Republican?
Let’s just remember that well more than 60 percent of Americans poor enough to qualify for these aid programs are working, sometimes multiple bad-paying jobs. More than 79 percent live in a working household. Cost and availability of child-care and lack of job skills may play important consideration for the rest. And that doesn’t count the numbers of people who are looking for work. Do they live in central cities in Democratic-leaning states? Surely many do, but not all. Are they disproportionately black, brown or other minority? Yes.
There is something here about pursuit of an American Dream that requires paid work as an essential marker of adulthood and responsibility. That kind of Calvinist work ethic has acquired an American cultural stamp, and even among capitalist countries, American stand out among Europeans or other white-majority cultures for insistence on American individualism and grit.
From the op-ed: “Despite all of the moral preening, for all the Trump administration’s solemn proclamations about the “dignity of work” and the economic “principles that are central to the American spirit,” these Medicaid regulations — and the thinking behind welfare administration more generally — are rarely as moral and all-embracing as their proponents would have us believe. It’s simply impossible not to see intent in racial disparities as large as the one these Medicaid waivers would generate. The GOP is making clear that these work requirements aren’t truly about the virtue of work, in general; they are about who needs to be working, and how much. And the answers to such questions are rarely grounded in the publicly espoused morality of help for all but in far more tribal considerations. Who deserves assistance, no strings attached? As it turns out, it’s those who look, think and vote like me. Who needs to get a firmer grip on those bootstraps and work to earn my help? Everyone else. “
The argument suggests that the framers of work requirements see good in Work, and bad in what they see as mooching off society. But then one must wonder what the explanation is for GOP-dominant states to create exemptions for poor whites.
A Washington Post editorialin January, when the rules were released, suggested that the United States puts more importance on work requirements than other democracies.
“This makes no actuarial sense, because the need for health care and work are not necessarily connected. It created the impediment to worker mobility known as “job lock.” And it created a large and chronic coverage gap for working-age, non-disabled adults who lacked jobs, or whose employers did not provide insurance but paid their employees too little for them to buy it on their own,” said the editorial.
Eight states have petitions pending for the relevant legal waiver that would allow them to impose work requirements. Of these, five expanded Medicaid through Obamacare, so the necessary effect would be to tighten eligibility for that population, ending coverage for at least some poor people who have it now.
This is a long, round-about set of issues that start with eliminating Obamacare. Eventually, all of it will end up biting us as a society. We say one thing about individualism and grit, but, in effect, show us that this is only for “real” Americans.