Doctors say new Medicaid rules ‘like asking people to work with an anchor on their back’

Administration’s policy allows states to impose work requirements for people on Medicaid, meaning sick or injured Americans ‘have to go to work, no matter what’

As many as 6.3 million people could lose Medicaid benefits as a result of the new change. Photograph: Jonathan Bachman/Reuters

Dr Gary Leroy’s patients are “salt of the earth”: inner-city people working in Dayton, Ohio as dishwashers, car mechanics and patient care assistants.

They do their best to make ends meet, but rarely do. Although the vast majority have jobs, most qualify for Medicaid, a public health insurance program which serves 74 million poor and disabled Americans. The program is almost entirely free, and based on need.

This week, the Trump administration announced a new policy that allows states to require Medicaid patients to work.

Six in 10 already do.

“I work with Appalachian, salt-of-the-earth, ‘Rah! Rah! America’ individuals,” Leroy said. “To have them clumped into – ‘Well, these people just don’t want to work’ – well, of course they want to work. I have all these working poor people that are making minimum wages.”

When people are required to work to receive healthcare cover, Leroy said: “It’s almost like asking people to work with an anchor tied to their back.”

The politics of welfare are complex. In the 1990s, under Bill Clinton, reforms transformed “pull-yourself-up-by-your-bootstraps” from an ethos to a matter of public policy. Now, the 10 states looking to implement work requirements for Medicaid coverage are all led by Republican governors or legislatures.

The changes allow states to require Medicaid recipients who are not children, elderly, disabled or pregnant to either work or perform “community engagement”, which can include going to school, looking for a job, volunteering or caregiving.

As many as 6.3 million people could lose Medicaid benefits as a result, an analysis by the left-leaning Center for American Progress found. About…

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