Dylan Scott covers health care for Vox. He has reported on health policy for more than 10 years, writing for Governing magazine, Talking Points Memo and STAT before joining Vox in 2017.
The Republican proposal to require people to work in order to receive Medicaid benefits poses an existential question about the very nature of government assistance: Do you need to do something to earn it?
For years, the GOP’s answer has been yes, some people should. These days, they have very specific people in mind: The 19 million Americans, most of them childless and nondisabled adults, who were not eligible for Medicaid until the Affordable Care Act expanded eligibility a decade ago.
House Republicans are so serious about imposing these new rules that they are trying to make them a condition of lifting the federal debt limit and averting an economic crisis. They don’t seem likely to succeed, given the Biden administration’s clear objections, but the mere demand reveals that the party remains as serious as ever about shrinking the social safety net. They seek to do so by dividing the deserving — in the case of Medicaid, pregnant women, children, those who are elderly or disabled — from the undeserving, who have to work to earn benefits.
“Assistance programs are supposed to be temporary, not permanent,” House Speaker Kevin McCarthy said in a speech on Wall Street outlining his party’s demands in the debt-limit talks. “A hand up, not a handout. A bridge to independence, not a barrier.”
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