To the Editor:

State legislators have proposed a bill they misname “N.C. Health Care for Working Families,” a Medicaid expansion bill with the most stringent work requirements ever. It would require that in order to have Medicaid health insurance, “able bodied” persons would have to regularly work 20 or more hours a week. This seems to make sense on its face. But, both the experience of other states and research evidence show that work requirements do not help unemployed people find jobs. Instead they result in huge holes in the social safety-net for our most vulnerable citizens.  

 The idea that a work requirement with the promise of health insurance would push someone uninterested in working to find a job is just plain wrong. Here’s why. The largest proportion of those who would be eligible for Medicaid expansion already work 20 hours a week or more. If they are “able bodied” and do not work, there is generally one or more valid reasons why. Here are some examples: inadequate or absent public transportation, health issues deemed not eligible for disability, mental illness or substance addiction, having a criminal record, caring for sick or aging family members, lack of job skills/training or illiteracy, just to name a few. It’s worth noting that those who work odd jobs or for employers that pay under-the-table in construction, landscaping, house cleaning or the like would not be eligible for coverage. Likewise, those who depend on seasonal work and spend several off-season months without employment would not meet the 20-hour minimum and would be dropped from coverage as well.    

Both research and common sense agree that when a person has access to nutritious food, safe housing and healthcare they are far more likely to find and keep steady work. If our legislators are actually in the business of improving the lives of N.C. citizens, they will listen to the evidence and pass Medicaid expansion without a work requirement. Please don’t leave the most vulnerable among us behind. We’re better than that. 

Barbara Kelton

Bryson City