Seen from outside Washington, the debt ceiling battle might seem like an abstract argument between the political parties over federal spending and deficits. But for millions of low-income Americans who depend on the federal government for health care and basic nutrition, the debate is about their very lives. That’s because Republicans have singled them out, yet again, as a prime target in this year’s extortion scheme.
The bill that Speaker Kevin McCarthy muscled through the House last month would impose tough new work requirements on Medicaid, food stamps (now known as the Supplemental Nutrition Assistance Program, or SNAP) and welfare for needy families. The demands would effectively cut off health care for 1.7 million low-income people and cut off food stamps for 275,000 people. House Republicans say that if their demands are not met, they will refuse to raise the debt ceiling, plunging the country into an unprecedented default and almost certainly creating a recession.
It’s not that there is some crisis or scandal gripping those federal programs; Republicans are making these demands simply because the debt ceiling gives them the opportunity to do so. And they are going after the same group of people their party has demonized for decades.
“I don’t think hard-working Americans should be paying for all the social services for people who could make a broader contribution and instead are couch potatoes,” said Representative Matt Gaetz of Florida, a member of the far-right House Freedom Caucus. (Mr. Gaetz’s deep concern about excessive spending didn’t stop him from requesting a $141.5 million earmark for a helicopter training hangar at Naval Air Station Whiting Field in his district.)
“Couch potatoes” isn’t that far from the “welfare queen” myth conjured by Ronald Reagan or Newt Gingrich’s 1994 claim that a system of orphanages was necessary because low-income babies were being dropped off balconies or showing up in dumpsters. None of these slurs had any significant basis in reality, and all were intended to whip up fears among members of the white middle class that they were being played for fools by people of color who were lazily living it up on taxpayer dollars and ignoring their family responsibilities.
But these largely racist attacks, very much including the one now on the table, persistently ignore the little-mentioned fact that a vast majority of the people receiving these benefits are already working or are unable to work. In 2021, 61 percent of the 25 million people on Medicaid were working in full- or part-time jobs. The rest were retired or disabled or taking care of small children or in school. Similarly, most food-stamp recipients work, and able-bodied adults younger than 50 are required to work in order to get more than three months of benefits in three years, unless they are taking care of children.
The existing work requirements don’t get discussed by the drill sergeants who want to whip the vast army of couch potatoes into shape; they want more people to work and to work longer hours. Mr. McCarthy’s bill would require adults 50 to 55 to work at least 20 hours a week to receive food stamps, no matter that people in that age bracket often find high barriers to employment.
The bill would also require many adults 19 to 55 to work 80 hours a month to receive federally subsidized health coverage from Medicaid. (States could pick up the cost of those who are cut off, but many would not.) As the Center on Budget and Policy Priorities notes, this requirement would particularly hurt low-income beneficiaries in states that expanded Medicaid under the Affordable Care Act and seems designed as a backdoor way of undermining the expansion. Republicans couldn’t repeal the act through the front door, so they are using the leverage provided by the debt ceiling to try to achieve their ideological aim. It’s yet another illustration of why the ceiling needs to be abolished.
It’s been clear for years that these kinds of work requirements don’t actually put people back to work; they just pry people away from the benefits they need. In 2018, Arkansas became the first state to impose very similar work requirements on Medicaid, before a federal judge ended the experiment the next year. A study in The New England Journal of Medicine found that 13 percent of Medicaid recipients there lost their health coverage — about 17,000 people — but that there was no significant change in employment.
One of the reasons for this phenomenon is that it’s very difficult for the subjects of these cruel experiments to report their employment or their search for a job to the state. Many people in Arkansas didn’t know about the work requirements or didn’t understand the rules or lacked internet access, the study found. But since the goal of Republicans is cutting spending, not putting people back to work, the burdensome rules do save billions through human suffering. The Congressional Budget Office estimated that the work requirements in the McCarthy bill, which the speaker said on Tuesday were a “red line” for his caucus, would save $120 billion over 10 years.
Once President Biden made the unfortunate decision to negotiate on the debt ceiling with the House hostage takers, the work requirements were on the table, and the president has not been clear about his intentions. On Sunday he told reporters that he had voted for work requirements currently in the law, apparently referring to cash welfare, and was waiting to see what the Republican proposals were. That was not exactly a comforting sign, particularly because the proposals are quite clear, though he did suggest that Medicaid changes were off the table. After progressives raised concerns, he issued a tweet on Monday condemning the harsher requirements for food benefits.
But with the default clock ticking and lives on the line, Mr. Biden needs to do more than send out a tweet. The most important thing the White House could do right now is say explicitly that using the debt ceiling as a cudgel to change federal safety net policy is unacceptable and inappropriate and will not be the subject of negotiation. Mr. McCarthy shouldn’t be the only one at the table with red lines, particularly when the health of millions of people is at stake.