EDITORIAL: The contorted logic of allowing states to require work as a condition for Medicaid

Jan. 19--The Trump administration is allowing states to impose work requirements on low-income adults as a condition for receiving Medicaid health coverage. The federal Centers for Medicare and Medicaid Services on Jan. 12 approved a request from Kentucky to implement work requirements. And Maine is one of a number of other states with work requirement requests pending before the federal government.

The policies will inevitably cause more low-income people to lose the health coverage they depend on, whether it's to be seen by the doctor or to afford prescription medications needed to treat chronic conditions. Yet in a contortion of logic, the Trump administration has tried to justify the move by arguing that work requirements could actually improve the health of the Medicaid-eligible population.

Gov. Paul LePage has traveled down this work requirement path before. In 2014, LePage reintroduced work requirements for low-income adults without children receiving food assistance to help them afford groceries and make ends meet. The move led to more than 10,000 low-income adults losing their food stamp benefits, often because they couldn't find work or volunteer assignments in the rural areas of the state where they live.

When more than 10,000 people lost access to food assistance, they didn't only contribute to Maine's generally increasing rates of food insecurity. It likely took a toll on their health.

A newly released report from the Center on Budget and Policy Priorities examines the impact of the Supplemental Nutrition Assistance Program -- the official program name for food stamps -- on beneficiaries' health. To start, food insecurity -- lacking consistent access to enough food at some point during the year because of a lack of resources -- worsens a person's health.

People living in food-insecure households spend 45 percent more on medical costs each year than comparable people who aren't having trouble putting enough food on the table, according to the center's summary of available research on SNAP and health. There's also a strong correlation between experiencing food insecurity and having a chronic illness.

Access to SNAP, the research concluded, reduced the likelihood of food insecurity by 30 percent, freeing up a limited resources in a household that its members can then spend on improving their health.

Unsurprisingly, SNAP recipients are more likely to report that they're in good or excellent health than low-income people not receiving SNAP. And the recipients spend 25 percent less on medical care than low-income people not receiving SNAP.

Work requirements that resulted in 10,000 people losing access to food assistance, then, inevitably harmed the health of thousands of low-income adults in Maine.

If work requirements in a food assistance program are likely to lead to a diminished state of health for thousands of low-income adults, it's not hard to imagine the damaging health effects of imposing work requirements in a benefit program designed explicitly to ensure that the poorest among us can access health care.

The Trump administration's logic for approving state requests for Medicaid work requirements simply doesn't pass muster and shouldn't be allowed to stand.

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