In September the state of Arkansas announced that 4,350 low-income individuals were dropped from Medicaid coverage for failing to comply with new work requirements imposed by the state and approved by the federal government. Thousands more are at risk of losing coverage over the next few months. What is troubling is that most of those covered by the requirement simply did not answer questions about their work activity on a website, the only state-approved method in a state where internet access lags well behind the national average.
Advocates for low-income families suspect that many Medicaid recipients were simply unaware of the requirement (the state has admitted that the “open rate” on emails about the requirement was less than 30 percent) or confused about how to meet it. Thus, two trends converged in Arkansas: reinforcing a stigma about receiving public assistance and using inefficient bureaucratic procedures to drive recipients off these assistance programs.
A similar dynamic is playing out as states impose drug testing on aid recipients, despite the enormous cost of such testing and the rarity of discovering drug users. At the federal level, President Trump’s administration has been openly trying to “get rid of” the Affordable Care Act with methods like defunding public information campaigns about the program and slashing funds for groups who help people fill out the paperwork properly. The Trump administration is also proposing that the use of noncash benefits like food stamps be counted against even legal immigrants who apply for green cards. The U.S. bishops, among others, are voicing concern that this move will have a chilling effect, discouraging families from seeking public aid even if they are eligible for it.
Cutting assistance for low-income families has never been very popular with voters, so it is tempting for politicians to use “painless” ways to shrink these programs, requiring applicants to fill out more forms and sowing confusion so that even eligible citizens simply give up. This passive-aggressive approach is inimical to the principles of transparent and efficient government. For any public benefit, the goal should be to cover as close to 100 percent as possible of those who are eligible for it.