It’s a ticking time bomb for our state budget. Medicaid spending, both nationally and here in Missouri, is growing at an alarming rate. Nationally, the number of people on Medicaid has more than doubled since 2000. Nearly 75 million individuals now draw Medicaid benefits. Perhaps most concerning is the explosion in the number of able-bodied adults on Medicaid. Over 28 million able-bodied adults are now dependent on the program, up from fewer than 7 million in 2000.
It’s not surprising then during the same time period taxpayer spending on Medicaid has grown. Total spending for the program has nearly tripled since 2000, and for able-bodied adults, it has increased by a startling 700 percent. In Missouri, over the past 10 years Medicaid has risen, as a percentage of the total state budget from 28 percent to nearly 40 percent. During the same time period, funding for K-12 education has actually fallen from 14 percent to 12 percent. In 2008, Medicaid cost the state about $6 billion. This year, the program is nearly $11 billion. Our state can’t sustain that sort of spending. Medicaid is eating nearly every additional dollar that comes into the budget and, if we don’t do something about it, it’s going to bankrupt our state.
It’s not just about the budget. We also have a moral obligation to not just add more and more Missourians to welfare. Any social welfare program that does not have a goal of moving able-bodied people from welfare to work is failing and doing more harm by trapping people in government dependency. People want to work and their fellow citizens want them to work. Hard work and responsibility is the path out of poverty, not welfare.
How do we stem the ever-rising tide of Medicaid enrollment and spending and put our priorities back in line? One step is to add a work requirement for able-bodied adults. That’s what my Senate Bill 948 would do. Able-bodied Medicaid recipients, age 19 to 64, would have to be engaged in at least 80 hours a month of any combination “work,” including traditional employment, but it could be volunteering at a local charity or attending classes at a local college or trade school. For example, a Medicaid recipient could work 10 hours per week and volunteer for 10 hours per week and that would satisfy the work requirement.
Medicaid was originally designed as a safety net for the truly vulnerable — the elderly and individuals with disabilities. Because these groups were generally either not of working age or couldn’t work due to a disability, work requirements were never included in the Medicaid program. Over time, the program has grown to cover other groups, like able-bodied adults, changing the original intention of the program. That means able-bodied adults can enroll without any requirements related to work and, as long as they keep their income low enough, they can receive Medicaid indefinitely. It’s not surprising then very few actually work full-time jobs.
It’s not too much to ask an able-bodied recipient of taxpayer-funded Medicaid to work in return for the benefits the taxpayers provide. It’s common sense. We have a responsibility to begin reforming Medicaid. Right now, taxpayers, year after year, write a blank check to a program that is failing our people and costing a fortune to do it. It’s obvious the status quo is not working. Encouraging work will help individuals escape poverty and is consistent with the values and morals of Missourians.
As always, I welcome your ideas, questions and concerns. You may contact me at the State Capitol as follows: (573) 751-1480, david.sater@senate.mo.gov or by writing to Sen. David Sater, Missouri State Capitol, Room 416, Jefferson City, MO 65101.
God bless and thank you for the opportunity to work for you in the Missouri Senate.