Pressure Mounts to Create a Pathway to Prosperity in Medicaid

During state budget hearings this week, Pennsylvanians learned some unwelcome news about healthy adults added to Medicaid under the Obamacare expansion: less than half are working.

The Department of Human Services (DHS) reports 495,719 of these 785,244 healthy adults earn no income. Without work, these individuals have no way of climbing out of poverty. And the ranks of unemployed on Medicaid are increasing.

Last year, DHS insisted work requirements weren’t necessary since only 490,000 healthy adults lacked income. At the time we highlighted how nearly half a million out-of-work Pennsylvanians—the populations of Harrisburg, Lancaster, Allentown, Erie, Scranton, and Reading combined—is a tremendous loss for our state economy and local communities.

When individuals receiving food stamps in Kansas and Maine were required to work or volunteer part time, the incomes for half of those who left the program doubled within a year. Returning to work improved their lives. 

Medicaid expansion also harms traditional enrollees by overwhelming an already strained program. Medicaid spending is growing at a rate of 5.7 percent, outpacing the state’s two percent economic growth. Plus, state and local taxpayers provide more resources to the healthy low-income Medicaid population than to families in severe poverty. The former population costing roughly $7,895 per capita, compared to $4,500 per capita, respectively.

Without reform, Pennsylvania will be forced to divert resources from other government services or take benefits from the very people Medicaid was created to serve.

A recent study from the Foundation for Government Accountability reports 250,000 disabled Medicaid enrollees are on a waiting list seeking home or community based care. In Pennsylvania, they estimate 9,728 are waiting for care. Even worse, an estimated 20,904 individuals have passed away on the waiting list since states began expanding Medicaid, including 154 people in Pennsylvania.

Pennsylvanians deserve better.

Yet, state officials have criticized the high cost of implementing a work requirement. DHS Secretary Teresa Miller claims proposed work requirements would cost the state $600 million and require 300 additional employees. That’s far above estimates from states implementing Medicaid work requirements. For instance, Kentucky is planning to spend $170 million to serve 350,000 healthy adults. Plus, states already have infrastructure in place to enforce similar work requirements for SNAP or Food Stamps.

The critical issue isn’t front-end administrative costs, but the human and financial cost of continuing with the failed status quo when evidence proves prioritizing work can reduce poverty and shrink waiting lists.

A waiver to implement work and community service for health adults is long-overdue. Success in Medicaid shouldn’t be judged by how many people join the program but by how many are able to rebuild their lives.