Work Requirements Seep into Policy, the Evidence Be Damned

(AP Photo/Jacquelyn Martin)

House Majority Leader Kevin McCarthy, House Speaker Paul Ryan, and House Majority Whip Steve Scalise on September 13, 2018

On Tuesday, Senate Majority Leader Mitch McConnell revealed what many had already predicted: Republicans would place blame for the deficit, which was ballooned by the $1.5 trillion Republican tax cut of 2017, on public assistance programs. McConnell told Bloomberg News that the deficit is “very disturbing, and it’s driven by the three entitlement programs that are very popular—Medicare, Social Security, and Medicaid.”

Indeed, conservatives are already putting forth policies to trim social programs, even as they are expanding work requirements to keep millions of low-income Americans from receiving assistance, and appointing people to administer such programs who have histories of mutilating them.

In their zeal to impose work requirements, they are serenely undaunted by the vast body of research that shows such requirements are stunningly ineffective. In their bill reauthorizing the Supplemental Nutrition Assistance Program (SNAP, or food stamps), House Republicans have proposed harsh work requirements that would affect recipients between the ages of 18 and 59 who have dependents over the age of six. (They are currently in conference with the Senate, whose bill imposed no such requirements). For its part, the Trump administration has allowed states to apply to attach work requirements to Medicaid. The first state to implement Medicaid work requirements, Arkansas, has already removed about 8,500 “noncompliant” individuals from the Medicaid program. The Trump administration is also recommending work requirements for recipients of housing assistance programs. Generally, these requirements demand at least 20 hours of work per week.

The latest entry in the mounting pile of studies about the negative consequences of work requirement policy is a new report from the Hamilton Project, a centrist economic policy project that’s part of the Brookings Institution. The report, by Lauren Bauer, Diane Whitmore Schanzenbach, and Jay Shambaugh, details who exactly would be—or already is—affected by work requirements, and how such policies are likely to do much more harm than good.

The report discusses why designing effective work requirement policy is difficult, given that it is based on an assumption about many people in poverty that is inherently flawed—that they are not working or not working enough hours because they simply don’t want to. “Proponents of work requirements would ideally only like to sanction individuals who are able to work, but choose not to,” the authors write. “But in practice strict enforcement of proposed work requirements will sanction many groups, including: those who are unable to work, those who are able to work but who do not find work, those who are working but not consistently above an hourly threshold, and those who are meeting work or exemption requirements but fail to provide proper documentation.”

The report provides many pages of data to substantiate these assertions. It documents who exactly will be affected by work requirements and what their reasons are if they’re not working.

Using Survey of Income and Program Participation data from 2013 and 2014, Bauer, Whitmore Schanzenbach, and Shambaugh analyzed data pertaining to each program’s different populations: adult SNAP recipients below the age of 59, who may or may not have dependents, and adult Medicaid recipients under the age of 64. Their findings show a low-income population facing numerous barriers to work.

Many of the surveyed workers faced a volatile labor market or had temporary health conditions that prevented them from working. Rather than not working at all, many worked at jobs that were unstable, and thus they dipped in and out of the labor market as jobs appeared and disappeared. “Many people are not truly on the sidelines,” the report reads, “as much as they are cycling in and out of the game.” Therefore, the authors note, most people in the affected population are part of the labor force, but they just may not always be able to work—and they would then lose coverage under a work requirement. The authors also point out that most people who lose coverage will actually be working or qualify for an exemption, but due to oversight and reporting complications, this may fail to be documented.

The report’s authors find that the most frequently cited reason that SNAP recipients who are not in the labor force have for not working for pay is a health problem or a disability. While people with disabilities are meant to be exempt from work requirements, many have undiagnosed disabilities—or disabilities that may not “meet the high standard set for disability benefits”—and thus may fall through the bureaucratic cracks. More than half of SNAP participants aged 18 to 49 with dependents between the ages of 6 and 17 who were not in the labor force said that their health was the reason. Of SNAP participants aged 50 to 59, 87 percent cited their health. SNAP recipients who did have a history of working cited work-related reasons—layoffs, shortened hours, workplace closures—to explain periods when they couldn’t work.

The trends were generally the same in the Medicaid population: Recipients were more likely to point to work-related reasons if they were in the labor force, and health reasons if they were not. The administration has argued that work requirements improve the health of low-income people, notwithstanding the often grueling conditions of many low-wage jobs. The health coverage provided by Medicaid and the more nutritious food provided under SNAP have, apparently to the Trump administration, no positive effect.

The administration’s drive to dismantle social programs took a big step forward Monday when President Trump appointed Mary Mayhew, former Department of Health and Human Services commissioner in the state of Maine, to oversee the Medicaid program in the federal Centers for Medicare and Medicaid Services. Like many Trump appointees, Mayhew is not being appointed for her skill at managing programs, but rather for her adeptness in destroying them.

As DHHS commissioner, Mayhew, according to the Portland Press Herald, “played a major role in eliminating nearly 70,000 people from the state’s Medicaid program,” as well as overseeing cuts to TANF and food stamps.

Last year, reporter Annie Lowrey, writing for The Atlantic, questioned Mayhew on the fact that poverty in Maine did not fall during her tenure, that extreme child poverty increased, and that hunger in the state had either not budged or increased.

In response, Mayhew questioned the validity of those surveys and statistics.

The person now in charge of the nation’s Medicaid also told Lowrey, “Our focus was to not evaluate individuals through the lens of their poverty or their current circumstance, but through the lens of their potential, and to restructure these programs to be pathways out of poverty through employment.”

Evaluating poor people’s actual circumstances would be more germane than evaluating their hypothetical potential when designing anti-poverty policy, of course. And if DHHS in Maine had actually done this, it might have realized poverty is due less to a person’s unrealized “potential” than to systemic problems like the low-wage labor market or the denial of health insurance to people who need it.

The most pernicious thing about Mayhew’s justification—that Maine’s policies were rooted in caring about people’s potential—is that these talking points often work. Many Americans support work requirements, because to some people who didn’t read the Hamilton Project paper or who don’t work in a low-wage job, such requirements may sound intuitively right in bootstrap America—rather than just making people in poverty poorer and sicker.

But hey, all that poverty and sickness just might pay for tax cuts.

Tax Cuts for the rich. Deregulation for the powerful. Wage suppression for everyone else. These are the tenets of trickle-down economics, the conservatives’ age-old strategy for advantaging the interests of the rich and powerful over those of the middle class and poor. The articles in Trickle-Downers are devoted, first, to exposing and refuting these lies, but equally, to reminding Americans that these claims aren’t made because they are true. Rather, they are made because they are the most effective way elites have found to bully, confuse and intimidate middle- and working-class voters. Trickle-down claims are not real economics. They are negotiating strategies. Here at the Prospect, we hope to help you win that negotiation.

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