[Editor’s note: “Morgan is Missing”, a reference to the 9th District’s Congressman Morgan Griffith, will be a recurring theme on this blog with multiple contributors. Let us know if you’ve got a contribution to make to this series or any others.]
As I went to bed last night, I learned that my Congressman, Rep. Morgan Griffith, just introduced the “Medicaid Individual Responsibility Bill” to Congress. The bill allows states to use their limited federal Medicaid dollars for implementing work requirement programs – including job training – for Medicaid recipients. After reading through his press release, a million questions spun around in my head. Is this what Mr. Griffith was working on last week when his constituents were begging for him to meet with them in town halls and other settings? Did any of his constituents ask for this bill? Does it meet any of our needs? If not, whose interests does it serve? How many able-bodied people are on Medicaid who are unemployed by choice anyway? And isn’t this really just a way to expedite getting people off the Medicaid rolls with no safety net starting in 2020 when the current Republican plan sunsets the Affordable Care Act’s expansion of Medicaid?
You’ll notice that this post is the first part of what will be a longer series on Rep. Griffith’s bill. We will explore answers to the above questions in future stories. But what I want to say on this topic right now is what kept me awake all night. I was ruminating on the notion of “individual responsibility” in the realm of health care.
I understand that, as an individual, I have some responsibilities when it comes to my own health. First and foremost, when I’m sick, I shouldn’t get other people sick. Even though I don’t do it well, I should stay home from work and, if necessary, go to the doctor to speed up my recovery so that I minimize the chances that I will spread my illness to others. Secondly, I should take proper measures to prevent myself from getting sick in the first place, by being vaccinated among other things.
If my Congressperson is going to introduce bills to address individual responsibility in health care, then it only makes sense to me that those bills would put systems into place that allow me and others to be individually responsible for our health – paid sick leave for more workers so that people can afford to stay home when they are sick and affordable access to doctors for preventative as well as emergency care, to name a few. Making it genuinely possible for us to be individually responsible for our health in these ways would be an appropriate role for government to play.
It turns out that about two-thirds of Montanans on Medicaid do work – they just don’t earn enough to purchase health care for themselves and their employers don’t offer it to them.
Instead, though, Griffith seems to be approaching individual responsibility from a different direction. If we assume best intentions, we might say that Griffith believes he is encouraging individual responsibility by demanding that poor people work instead of relying on the government to meet their needs. And if a large number of able-bodied people on Medicaid were unemployed by choice, then perhaps that would be an understandable hypothesis.
But, as far as I can tell, the numbers don’t support that argument. This type of a work-requirement attached to Medicaid was attempted last year in Montana, but it turns out that about two-thirds of Montanans on Medicaid do work – they just don’t earn enough to purchase health care for themselves and their employers don’t offer it to them. Presumably some portion of the other third are made up of people who Griffith exempts from the requirement anyway. I’ve reached out to Joan Alker at Georgetown University McCourt School of Public Policy for help in finding these statistics for Pulaski and the 9th District and will update if I get more local details. In the meantime, I can rely on my own knowledge of people’s lives right here in Pulaski to conclude that there are a significant number of people in our community who work extremely hard, but without the benefit of employer-paid health insurance or high enough wages to be able to afford to purchase their own coverage, especially if they have pre-existing conditions.
A generous assessment of Griffith’s intentions might also be compelling if there weren’t already a whole range of education and job training funds available from the federal and state governments. But I don’t think that’s the case either. (Again, we may look into this question more deeply in future installments, too.)
It would also be understandable that Griffith was interested in encouraging individual responsibility with this bill if he himself were individually responsible for his own health insurance. But instead, even though his staffers go to great lengths to claim otherwise, we the (Virginia) taxpayers foot Griffith’s insurance bill since he has opted to be on his wife’s plan (his wife is a state judge). And really no one with employer-paid plans can call ourselves “individually responsible” for our health insurance when our employers’ contributions are untaxed and therefore, in effect, government subsidies.
All of which leads me to the conclusion that, in spite of its name, Rep. Griffith’s bill is not at all about increasing individual responsibility. Instead, it’s about decreasing corporations’ responsibility not only for funding Medicaid (because no one will be surprised to see a decrease in Medicaid taxes in the future), but also for paying for job training programs for their employees.
Selling bad policy using the notion of individual responsibility isn’t limited to Republicans. Democrats have done it over the past few decades, too. But I wish everyone – regardless of political persuasion – would stop. At the very least, it would help me get some more sleep. And getting more sleep, says science, is the best medicine…especially if you can’t afford to pay for actual medicine.