Nevada should impose work requirement for Medicaid enrollees

Even though Congress could not find a way to repeal the budget-busting, economy-distorting Affordable Care Act, affectionately known as ObamaCare, there are still a few things the states can do to ameliorate its impact.

Chief among these, according to a report prepared for the Nevada Policy Research Institute and the Washington Policy Center by Dr. Roger Stark, is to implement work requirements for able-bodied Medicaid enrollees. The Trump administration announced recently that it is willing to accept waiver requests — known as 1115A waivers — from states that wish to impose a work requirement.

“Applying for a waiver to implement work requirements is a common-sense reform, and it’s one that’s already supported by the administration,” says NPRI policy analyst Daniel Honchariw. “Medicaid should help its able-bodied members who are willing to work, rather than encouraging an unsustainable and demoralizing cycle of dependency.”

Honchariw notes that 60 percent of the Nevadans who gained free Medicaid coverage under ObamaCare’s expansion of the program — approved by Republican Gov. Brian Sandoval, by the way — did not earn a penny of income in all of 2015. Expanded Medicaid now covers 600,000 Nevadans at annual cost of about $5,700 each.

“Such costs are unsustainable over the long-run without dramatic tax increases,” Honchariw states.

According to Dr. Stark, ObamaCare has resulted in only 20 million of the 50 million uninsured people before the law was passed — without a single Republican vote, by the way — to gain health insurance coverage. A large portion of those were handed Medicaid. In Washington state, 80 percent of the newly insured were placed on Medicaid.

“Obamacare has raised insurance premiums for virtually everyone in the country outside of the free Medicaid entitlement. Health care spending was 17 percent of the economy when the ACA became law,” Stark writes. “By 2021, with the ACA in place, estimates show that the country will spend 21 percent of the annual economy on health care.”

He said this past year the cost of Medicaid was $545 billion nationally and is projected to grow to $700 billion by 2020.

Studies have found that the health outcomes for people covered by Medicaid are no better than the uninsured.

We encourage Nevada’s lawmakers to take advantage of the work-requirement waiver and other options to curb the cost to taxpayers and break the cycle of dependency such entitlements foster. —TM


  1. Art Brenner says:

    I agree, but I don’t think Mr. Mitchell goes quite far enough regarding the 1115A waiver and imposing work requirements for able bodied (emphasis on ABLE bodied) medicaid recipients. I think the requirement to work should be accompanied by a requirement to be trained. This country is in desperate need of infrastructure repair and replacement. Able bodied medicaid recipients should be required to learn one of the many crafts and trades necessary for work on the national infrastructure – offering living wages. Eventually, these folks could become contributing members of society. Further, each course of training should be time limited. Each person would be required to train for a specific craft or trade within a specific period of time. Once the course of training is completed, the trainee should then be given a limited period of time to gain employment in their trained area, after which their eligibility for medicaid would expire.

    • Teri Nehrenz says:

      That is an excellent idea Art! Why can’t the politicians come up with these obvious and simple solutions? I agree, training should go with the program for the ABLE bodies otherwise, it’s pointless to put them to work for less than liveable wages. Going further, I think that ABLE bodied welfare recipients should be required to work as well (lots of litter in the streets to be picked up) or be required to attend some sort of college/vocational program while receiving benefits. Once they graduate, then give them 6 more months to get their acts together and that’s it. Teach these people to fish rather than throwing them the fish’s bones; welfare doesn’t even afford you the whole fish.

  2. David Petrillo says:

    Again, we have a Thomas Mitchell column that distorts what is really going on. I challenged him and anyone else a few weeks ago to go out and interview someone who is able bodied, not caring for a parent or child, and not waiting to be called back to work from a temporary layoff. I am sure you could find one or two people but it is nowhere near what Mitchell implies. I know that is not what the Alt Right wants to hear. They have to have someone or a class of people to demonize. It might as well be the elderly, the disabled, the working poor, and people who are on a temporary layoff.

    And I loved how Mitchell said that being uninsured is just as good as being on Medicaid. I guess that is really a condemnation of the health system in the US, or the lack thereof. Someday our Country will come to its senses and enact an affordable health plan that has already been adopted by all the rest of the world. But that would mean that the drug companies, for profit hospitals and others in the current lucrative medical industry would not be able to stuff their money in those tax free Swiss accounts.

  3. Terry Donnelly says:

    Mr. Mitchell’s comment about healthcare results being equal within Medicaid and uninsured folks is a testament to our care system. Medicaid isn’t a care delivery, it is insurance to pay for it. The uninsured go to the emergency room, get quality treatment, and then are unable to pay for the services and the cost is passed along in the form of higher premiums for insured citizens. Mr. Mitchell also complains about high costs and this could be partially addressed by getting covered care to every citizen.

  4. It is never a wise idea to open an op ed with a misstatement like “Even though Congress could not find a way to repeal the budget-busting, economy-distorting Affordable Care Act, affectionately known as ObamaCare”. The republicans have found the way in the passing of the Great Trump Tax Scam. As it bleeds the working class through the years, budget cuts will have to follow with Medicaid, Medicare, and SSI the obvious targets. Then even the Alt Right and Mr, Mitchell will have to scramble to put their future together.

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