Bernick: Adding work requirements to Medicaid isn’t a bad idea

Over the past years that I ve been part of America s job training system work requirements for regime benefits have been proposed several times Each time these work rules have been initially denounced by opponents as cruel punitive blaming the victim with accompanying fears that benefit recipients were not ready to be employed and would lose needed benefits Yet each time work requirements have been implemented they have resulted in increased employment and other life benefits for a vital segment of participants their families and local communities Those are the metrics by which to measure success reducing the rolls of benefit programs has not been the main goal sought by advocates of previous work requirements The results have been documented over the years by scholars representing a range of viewpoints Harry Holzer of Georgetown Lawrence Mead of New York University and the professional research staff at MDRC to cite a limited These results have been seen with work rules imposed for welfare recipients recipients of various general assistance benefits and parents who owe child endorsement They will be seen again if the proposed Medicaid work rules go forward and are implemented seriously and with purpose Individuals on welfare and other benefit programs often need a push into the job world They may lack confidence have become discouraged or have no idea how to get started Work rules provide that push They also provide a promotion infrastructure for job placement and retention America Works is one of the nation s largest job agencies serving unemployed people referred by various regime benefit programs Each participant is assigned a job counselor and develops an individual employment plan The counselor is to identify job openings assist the participant in applying advocate for the participant to employers The counselor is also trained to be the coach whom all job seekers need keeping spirits up through the likely multiple rejections serving as a challenge solver during the placement process and troubleshooting when job issues inevitably arise after placement At each stage the participant is no longer on their own Tried and tested Since the early s work rules have been the bulk extensively tested studied and monitored in the welfare system first as pilot projects by individual states and later under the federal welfare transformation of Welfare scholars of the s including Manpower Demonstration Research Corp President Judith Gueron would highlight how much previous welfare policies divorced from work requirements had underestimated the work orientation and strengths of welfare recipients Researchers of welfare-to-work programs of the s and early s at the Urban Institute and with a consortium of university centers would confirm the widespread work orientation of welfare recipients as well as their abilities to function in the work world This is not to romanticize welfare-to-work Despite the counseling and supports transportation subsidies child-care subsidies a good number of participants drop out during the placement process or within a year of job placement They do so because of chaotic personal lives or mental illnesses or developmental disabilities that the job placement system is unable to address They do so because of an absence of a family configuration or because they don t want to menace the other housing healthcare and food stamp benefits they receive beyond the welfare payment Even those who obtain jobs often struggle economically At the same time for those who are able to maintain a job the job frequently brings values beyond the income Jason Turner the architect of the early Wisconsin welfare-to-work successes and later commissioner of New York City s Human Support Administration references the power of the job drawing on his experiences over four decades A job brings structure to participants in work requirement programs somewhere to go every day It brings a new confidence which can translate into addressing daily life responsibilities that previously seemed overwhelming In theory the importance of employment is hailed across the political spectrum In practice though the ties of ruling body benefits to employment have been weakened in the past two decades and so multiple opportunities to demonstrate the value of this connection have been missed Welfare-to-work requirements have been diluted in major cities and blue states Employment efforts for recipients of Supplemental Shield Income and Social Protection Disability Insurance have stalled Guaranteed incomes schemes removed from employment have gained currency Not a punishment The current proposed Medicaid work rules exclude Medicaid recipients with disabilities mental strength conditions and adults with young children They also exclude the large number of Medicaid recipients who work part time or full time None of these Medicaid recipients are at threat of losing healthcare benefits For the remaining group the able-bodied without young children America has a vast workforce organization at the ready to provide job placement services No new bureaucracy is needed It is a infrastructure of community-based agencies workforce intermediaries and local American Job Centers with lengthy experience in placing workers who have been outside the job mainstream Though the first jobs that Medicaid recipients obtain will mainly be entry-level lower-wage jobs the recipients will be better off economically and at least on a path to the workforce system s goal of a job a better job a career Medicaid work rules are not cruel or punitive They help Americans to reclaim the power of the job Michael Bernick a former director of the California Labor Department serves on the state s Behavioral Strength Oversight Commission Los Angeles Times Distributed by Tribune Content Agency