It seems Republicans everywhere want to have work requirements for people who receive Medicaid health insurance. Our governor has said he’s on board, as has the interim director of the Department of Health and Welfare. The legislature has long argued for this, and they are again. Idaho has a request pending. It has not been approved by the Trump administration or this Biden one.

I understand their concern. Why should us taxpayers give our tax money to folks loafing on the couch all day? If that’s the case.

I first ran into this sentiment when I was campaigning for office. The local laborer’s union gave me a chance to make my pitch to them. Democrat, Union, you’d think we were simpatico. Maybe not.

I introduced myself and then asked them what they wanted from the state government. The young guys were reluctant, but finally a guy spoke up. “Why don’t we drug test people who want welfare?”

I told him I would look into it. After I got elected, I did.

Some states had imposed this testing. It had become a meme. That is, there was widespread belief that druggies were taking our tax dollars.

The actual numbers showed that the cost of drug testing and the administration of this requirement had added significantly to the taxpayers cost of the program. Further, the number of folks using drugs on Welfare was well below the number of the general population. So just what is your point?

I believe most folks do not want to give something out through government-imposed taxes to another of their fellow citizens who might be undeserving of their generosity. I understand this sentiment. And I’m an Idaho Democrat.

But the laws we write are supposed to promote domestic tranquility and the common good. Anyone remember that?

So, let’s look at the work requirement proposed for Medicaid health insurance.  Idaho’s proposal has many exceptions for “work”. Caretakers, moms, folks recently unemployed are exempted. So, who might be abusing this government benefit? I would argue, it’s a very small fraction of the Medicaid population.

I guess you want to build a department of government to look for these scofflaws and make sure they don’t have health insurance that we are all paying for.

Given our current system assumption that health insurance is a work-related benefit, it makes sense that we should be pushing people to gain employment, and then their health insurance would be the employers problem, not us taxpayers.

So, here’s the deal I offer you “work requirement” afficionados. And I believe it is a plan that would be accepted by our federal partners. Neither Trump nor Biden have approved our current proposal.

Idaho should propose to the federal government, our Medicaid partner since they pay 70% of the bill, a study.

We get to impose Medicaid work requirements on half of the folks who apply for Medicaid. We study this half, and the half that don’t have the requirements. We watch them for their long term, let’s say five years, outcomes. How many become employed and off the dole? How many just stay uninsured and a burden on us all.

Do we really help anybody with this program?

I have my bias.

You probably do too.

Let’s study the question.

It comes down to the question of whether you believe people, our society, your neighbors, all of us, are better suited to serve the common good if we have health insurance.

Since the health insurance industry is a significant portion of many people’s retirement portfolios, I doubt any major disruption is in the cards.

But if you want to drain the swamp, this is a good place to start.

Let’s make a deal.

About ddxdx

A Family physician, former county coroner and former Idaho State Senator
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