Wednesday, March 13, 2024

Sid Salter: In an Election Year, are Medicaid Work Requirements a Possible Biden Compromise?

The current effort to make a partial expansion of Medicaid under the Affordable Care Act in Mississippi appears to have hit a legislative logjam in the State Senate over the issue of work requirements.

The Mississippi House version of expanded healthcare coverage for Mississippi’s working poor contains a work requirement. Senators on the other end of the Capitol worry that the House work requirements can’t or won’t be enforced by the federal government.

Other states like Kentucky and Arkansas that have engaged in some form of Medicaid expansion have attached work requirements only to see the feds under President Joe Biden reject those requirements. Kentucky’s plan was blocked by a court order while Arkansas saw some 18,000 new Medicaid recipients fail to report their work activities and ultimately lost coverage.

The status quo nationally is that Republicans favor work requirements for the able-bodied recipients of government assistance and the Democrats generally oppose them. That’s been reliably true in the Medicaid expansion fight and particularly so in the ten states whose Republican leaders have resisted expansion - Alabama, Florida, Georgia, Kansas, Mississippi, South Carolina, Tennessee, Texas, Wisconsin, and Wyoming.

But Republicans and Democrats already have work requirement data available from the work requirements attached to the Supplemental Nutrition Assistance Program (SNAP) or more commonly called “food stamps” that have been analyzed by the Congressional Budget Office along with similar requirements in Medicaid and the Temporary Assistance for Needy Families (TANF) program.

That June 2022 CBO analysis found that “(m)aking the receipt of benefits contingent on working or preparing to work has substantially increased the employment rate of the targeted recipients in TANF during the year after they enter the program and by a smaller amount in later years. Work requirements in SNAP have increased employment less; in Medicaid, they appear to have had little effect on employment. “Although some people have higher income because they work more to meet the programs’ requirements, other people do not meet the work requirements and are left with little income from in-kind benefits, cash payments, earnings, or other sources. Overall, the increase in total earnings from TANF’s work requirements is about equal to the reduction in benefits. In contrast, work requirements in SNAP and Medicaid have reduced benefits more than they have increased people’s earnings.

“In general, tightening work requirements would reduce federal spending by decreasing the amount of benefits provided; the extent of the budgetary savings would depend on the details of the policy. If lawmakers used the savings from tightening work requirements to increase work supports that helped recipients meet those requirements, the federal budget would change little (or perhaps not at all),” the CBO analysts concluded.

The shorthand on all that is that work requirements aren’t as effective as we as taxpayers are led to believe. Recipients struggle to understand or comply with reporting requirements, the bureaucracy and red tape are confusing, and many drop off the rolls over time. That’s a bad outcome for healthcare, but it does help balance the fiscal growth of the overall program.

But in red states, work requirements satisfy our strong beliefs about the able-bodied having a work ethic and government assistance being temporary.

For Mississippi lawmakers, it would seem that their efforts toward installing a work requirement in Medicaid will be bolstered either by the Biden Administration compromising and seeing expanded coverage being worth accepting the work rules during a tight election year OR by the re-election of former President Donald Trump whose administration granted Section 1115 waivers and allowed work requirements. The Supreme Court had been set to review the legality of Medicaid work requirements in 2022 focused on Arkansas and New Hampshire actions, but dropped the case when the Biden Administration threw out most Trump-driven Section 1115 grants of waivers for work requirements.

Now Biden the Candidate must decide if those same work requirements could help him close the Medicaid expansion gap in the red states. All the while, Mississippi taxpayers are through their federal taxes already paying for expanded Medicaid benefits in 40 other states while our own working poor are not eligible for those same benefits.

Sid Salter is a syndicated columnist. Contact him at


Anonymous said... perhaps the feds recognize that some of those who need coverage were working and can't because they are sick or have been disabled in a way that with coverage for surgery or a prosthetic could return to work given the way legislatures try to use an issue rather than solve it?

If you didn't "get" the political "game" before, the trashing of a damn good border bill ought to have done it for you!

But, gee my skepticism comes from knowing that more than a few well known wealth Republicans have " undocumented" employees pay less with cash !

Wolfe needs to put a watch on some wealthy contributors to see who goes in and out.

Anonymous said...

"The status quo nationally is that Republicans favor work requirements for the able-bodied recipients of government assistance and the Democrats generally oppose them."
That statement tells you everything you need to know. Able-bodied Democrats like their free stuff, but they don't like anyone telling them they should work.

Anonymous said...

No Pigott, No Pulitzer.

Saltwaterpappy said...

The Founding Fathers of America knew that for our Republic to continue to succeed, it is absolutely necessary that a sense of "virtue" exist among the citizens. One of the key elements of the "virtue" they expoused is "industriousness". They were aware that the disease of slothfulness is a dagger, not only to the individual recipients, but it also creates resentment among the hardworking producers in society. Therefore, requiring able bodied recipients to work, in order to receive Medicaid benefits, is not asking too much of them.

Anonymous said...

Not reading Salter's meaningless slop!

Anonymous said...

"Mississippi taxpayers are through their federal taxes already paying for expanded Medicaid benefits in 40 other states while our own working poor are not eligible for those same benefits."

Gee - maybe they should consider moving to one of the 40 states that will give them free insurance without requiring them to work - sounds like a win-win situation for everyone......

Anonymous said...

Dayum, Salty...You've turned over a new leaf!

Anonymous said...

I’m a Democrat, and I believe there should be an “ actively seeking work” requirement. Better healthcare access through Medicaid will improve MS in so many ways. Tate Reeves is a heartless panderer to the rich. I hope the Legislature stands up to his veto threat and expands Medicaid.

Saltwaterpappy said...

4:38----Not really. I am just a lifetime Conservative who calls it like it is.

Recent Comments

Search Jackson Jambalaya

Subscribe to JJ's Youtube channel


Trollfest '09

Trollfest '07 was such a success that Jackson Jambalaya will once again host Trollfest '09. Catch this great event which will leave NE Jackson & Fondren in flames. Othor Cain and his band, The Black Power Structure headline the night while Sonjay Poontang returns for an encore performance. Former Frank Melton bodyguard Marcus Wright makes his premier appearance at Trollfest singing "I'm a Sweet Transvestite" from "The Rocky Horror Picture Show." Kamikaze will sing his new hit, “How I sold out to da Man.” Robbie Bell again performs: “Mamas, don't let your babies grow up to be Bells” and “Any friend of Ed Peters is a friend of mine”. After the show, Ms. Bell will autograph copies of her mug shot photos. In a salute to “Dancing with the Stars”, Ms. Bell and Hinds County District Attorney Robert Smith will dance the Wango Tango.

Wrestling returns, except this time it will be a Battle Royal with Othor Cain, Ben Allen, Kim Wade, Haley Fisackerly, Alan Lange, and “Big Cat” Donna Ladd all in the ring at the same time. The Battle Royal will be in a steel cage, no time limit, no referee, and the losers must leave town. Marshand Crisler will be the honorary referee (as it gives him a title without actually having to do anything).

Meet KIM Waaaaaade at the Entergy Tent. For five pesos, Kim will sell you a chance to win a deed to a crack house on Ridgeway Street stuffed in the Howard Industries pinata. Don't worry if the pinata is beaten to shreds, as Mr. Wade has Jose, Emmanuel, and Carlos, all illegal immigrants, available as replacements for the it. Upon leaving the Entergy tent, fig leaves will be available in case Entergy literally takes everything you have as part of its Trollfest ticket price adjustment charge.

Donna Ladd of The Jackson Free Press will give several classes on learning how to write. Smearing, writing without factchecking, and reporting only one side of a story will be covered. A donation to pay their taxes will be accepted and she will be signing copies of their former federal tax liens. Ms. Ladd will give a dramatic reading of her two award-winning essays (They received The Jackson Free Press "Best Of" awards.) "Why everything is always about me" and "Why I cover murders better than anyone else in Jackson".

In the spirit of helping those who are less fortunate, Trollfest '09 adopts a cause for which a portion of the proceeds and donations will be donated: Keeping Frank Melton in his home. The “Keep Frank Melton From Being Homeless” booth will sell chances for five dollars to pin the tail on the jackass. John Reeves has graciously volunteered to be the jackass for this honorable excursion into saving Frank's ass. What's an ass between two friends after all? If Mr. Reeves is unable to um, perform, Speaker Billy McCoy has also volunteered as when the word “jackass” was mentioned he immediately ran as fast as he could to sign up.

In order to help clean up the legal profession, Adam Kilgore of the Mississippi Bar will be giving away free, round-trip plane tickets to the North Pole where they keep their bar complaint forms (which are NOT available online). If you don't want to go to the North Pole, you can enjoy Brant Brantley's (of the Mississippi Commission on Judicial Performance) free guided tours of the quicksand field over by High Street where all complaints against judges disappear. If for some reason you are unable to control yourself, never fear; Judge Houston Patton will operate his jail where no lawyers are needed or allowed as you just sit there for minutes... hours.... months...years until he decides he is tired of you sitting in his jail. Do not think Judge Patton is a bad judge however as he plans to serve free Mad Dog 20/20 to all inmates.

Trollfest '09 is a pet-friendly event as well. Feel free to bring your dog with you and do not worry if your pet gets hungry, as employees of the Jackson Zoo will be on hand to provide some of their animals as food when it gets to be feeding time for your little loved one.

Relax at the Fox News Tent. Since there are only three blonde reporters in Jackson (being blonde is a requirement for working at Fox News), Megan and Kathryn from WAPT and Wendy from WLBT will be on loan to Fox. To gain admittance to the VIP section, bring either your Republican Party ID card or a Rebel Flag. Bringing both and a torn-up Obama yard sign will entitle you to free drinks served by Megan, Wendy, and Kathryn. Get your tickets now. Since this is an event for trolls, no ID is required. Just bring the hate. Bring the family, Trollfest '09 is for EVERYONE!!!

This is definitely a Beaver production.

Note: Security provided by INS.

Trollfest '07

Jackson Jambalaya is the home of Trollfest '07. Catch this great event which promises to leave NE Jackson & Fondren in flames. Sonjay Poontang and his band headline the night with a special steel cage, no time limit "loser must leave town" bout between Alan Lange and "Big Cat"Donna Ladd following afterwards. Kamikaze will perform his new song F*** Bush, he's still a _____. Did I mention there was no referee? Dr. Heddy Matthias and Lori Gregory will face off in the undercard dueling with dangling participles and other um, devices. Robbie Bell will perform Her two latest songs: My Best Friends are in the Media and Mama's, Don't Let Your Babies Grow up to be George Bell. Sid Salter of The Clarion-Ledger will host "Pin the Tail on the Trial Lawyer", sponsored by State Farm.

There will be a hugging booth where in exchange for your young son, Frank Melton will give you a loooong hug. Trollfest will have a dunking booth where Muhammed the terrorist will curse you to Allah as you try to hit a target that will drop him into a vat of pig grease. However, in the true spirit of Separate But Equal, Don Imus and someone from NE Jackson will also sit in the dunking booth for an equal amount of time. Tom Head will give a reading for two hours on why he can't figure out who the hell he is. Cliff Cargill will give lessons with his .80 caliber desert eagle, using Frank Melton photos as targets. Tackleberry will be on hand for an autograph session. KIM Waaaaaade will be passing out free titles and deeds to crackhouses formerly owned by The Wood Street Players.

If you get tired come relax at the Fox News Tent. To gain admittance to the VIP section, bring either your Republican Party ID card or a Rebel Flag. Bringing both will entitle you to free drinks.Get your tickets now. Since this is an event for trolls, no ID is required, just bring the hate. Bring the family, Trollfest '07 is for EVERYONE!!!

This is definitely a Beaver production.

Note: Security provided by INS