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medicare for all
Work Requirements for Medicaid Imply a Federal Duty To Hire
If Congress actually imposes a work requirement for Medicaid recipients, it should also enact a governmental program to employ anybody who is unable to find work elsewhere.
Jun 12, 2025
Republicans in Congress are planning to slash funding for Medicaid in order to help pay for major tax reductions for wealthy Americans and corporations. But they don't want to cut Medicaid openly, because it will gravely injure many people who voted for them.
One way to cut Medicaid expenditures without overtly reducing benefits is to increase required paperwork. Additional bureaucratic hassle will discourage people from applying for what they are eligible for. The "big beautiful bill" currently discussed in Congress incorporates this strategy.
The major provision aimed at saving money requires Medicaid recipients to work at least 80 hours a month.
Until American conservatives wise up and emulate the conservatives in Taiwan, who introduced universal medical insurance there, we will have to live with a lot of unnecessary complexity and inflated administrative expense.
The work requirement requires frequent verification that a recipient is employed—more hassle. It will deny coverage to individuals who—for one reason or another—can't find work.
Given likely job loss due to artificial intelligence, mass corporate layoffs, and huge reductions in government payrolls, the number of people without insurance because they can't find work will likely be large.
This policy will be rather hard on people who through no fault of their own are unable to find work. And inability to get medical treatment may leave some people in such poor health that it makes it even harder to find and hold a job.
The work requirement, though, appears to be popular when people are polled. But many of the polled people may underestimate the danger that they themselves will lose their jobs, their job-related insurance, and their eligibility for Medicaid.
Fortunately, the bad consequences of the requirement could be completely eliminated by one simple additional government policy: that it will hire anybody who is otherwise unable to find work.
There is, of course, no end to the useful work that people employed by the government could do: elderly people who need help in their daily lives, children who could use tutoring, parks that need to be cleaned up, hiking trails that need maintenance, etc.
But guaranteeing jobs would cost the government (which is to say taxpayers) money, which would conflict with the desire to save money prompting Congress to restrict Medicaid eligibility in the first place.
And a guaranteed jobs policy, morally necessary in order to make federal medical policy less unjust, would also make public policy even more complicated than it already is.
A better solution to this problem would be to completely decouple medical insurance from employment. The United States is the only developed country that does not guarantee medical insurance for everyone, employed or unemployed, rich or poor, young or old.
Instead, we have a tremendously complicated system with different government programs for the old, for children, for Native Americans, for veterans, for the poor. As people's situations change, they can "churn" from one program to another, all too often falling into the gaps between programs, which leave them totally uncovered.
We'd all be better off, and would probably save money, if Congress wiped out all of today's complicated government insurance programs—including Obamacare, Medicare, and Medicaid—replacing them with a single program insuring everybody no matter their age or work status.
Unfortunately, American conservatives have been trained to reject a single-payer program like Medicare For All as "socialistic," without inquiring into the benefits such a program would produce. And enacting a major program like this would require bipartisan support.
Until American conservatives wise up and emulate the conservatives in Taiwan, who introduced universal medical insurance there, we will have to live with a lot of unnecessary complexity and inflated administrative expense.
Given this unpleasant fact, if Congress actually imposes a work requirement for Medicaid recipients, it should also enact a governmental program to employ anybody who is unable to find work elsewhere.
Since it is unlikely that Congress will do this, the best outcome we can realistically hope for is that the work requirement for Medicaid recipients will be stripped out of the bill in the Senate.
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We've Endured a Half-Century of Kleptocrats' Plunder of People's Wealth and Health
Neoliberalism has spurred 45 years of financialization, as Wall St. pillages-for-profit every sector, from healthcare to housing.
May 21, 2025
The Franklin D. Roosevelt administration prioritized a standard for economic and democratic empowerment of the people. FDR's New Deal advanced the common good and an economy for the people. The 1935 Social Security Act became the boilerplate for universal healthcare.
The post-WWII "Golden Age" of capitalism boosted economic growth, people's prosperity, and middle class expansion, lasting until 1975—subsequently displaced by global neoliberal capitalism.
Principle Political Dichotomy: Corporatists vs. Working People
Since the 1970s white supremacists, Christian nationalists, and aspiring oligarchs have converged under the Republican Party umbrella to seek deconstruction of democracy toward harnessing wealth and political power, while promoting supremacistentitlement—the presumed right to criminalize and hold hostage other people's lives based on gender, ethnicity, religion, and class wealth.
Nixon Supreme Court appointee Lewis Powell's 1971 Memorandum, termed a "capitalist coup," further galvanized corporate money toward rewrite of law, policy, and judicial precedent to consolidate corporate political power.
Since Reagan, continual huge tax cuts for wealthy corporatists have spiked national deficits, paid for with deficit-cutting on the backs of working people by cutting public and social programs.
Kleptocracy, also known as "socioeconomic thievery," describes the half-century robbery of the American people by corrupt leaders who expropriate wealth of the governed for their own gain. Contemporary Gilded Age Robber Barons continue to expropriate people's wealth. A RAND Corporation Report reveals that from 1975-2023 the top 1% robbed $79 trillion from the bottom 90%. Had earnings remained equitably distributed at pre-1975 levels, the average worker in the bottom 90th percentile would earn $32,000 more annually.
Even as the neoliberal "greed is good" ethic prioritized enhancement of shareholder profits, Reagan administration neoliberalism supercharged wealth transfer upward, crushing unions and wages, gutting antitrust law, deregulating banks and industries, enabling predatory private equity practices, and legalizing stock buybacks that continue to multiply billionaires' wealth.
Neoliberalism has spurred 45 years of financialization, as Wall St. pillages-for-profit every sector, from healthcare to housing. Kleptocrats leverage rivers of dark money to capture media and dominate lobbyist-controlled legislatures and elections, flooding the 2024 election with nearly $2 billion.
Commodification of Health for Profit Betrays the Original Intent of Medicare
The Social Transformation of American Medicine, by sociologist Dr. Paul Starr is a Pulitzer Prize-winning chronicle of corporate takeover of U.S. healthcare. Starr describes former President Richard Nixon as the first mainstream political leader to "take deliberate steps to change American healthcare from its longstanding not-for-profit business principles into a for-profit model to be driven by the insurance industry."
A 1971 video exchange between President Nixon and his aide John Ehrlichman celebrated the Kaiser CEO's prioritization of profit over healthcare. Enthused Ehrlichman, "...All the incentives are toward less medical care, because the less care they give them, the more money they make."
Ostensibly intended to cut costs and improve healthcare access, Nixon's 1973 HMO Act advanced the concept of for-profit "managed care" health models. Each manifestation of managed care, including Accountable Care Organizations and Medicare Advantage, have proved increasingly profitable for Wall St. and the health industrial complex.
With passage of the 2003 Medicare Modernization Act, former President George W. Bush spearheaded privatized, for-profit Medicare Advantage insurance, purportedly written to "compete" with Original Medicare to save costs and improve healthcare access. Failing to do either, Medicare Advantage betrays the original intent of Medicare—to universalize coverage and rein in health costs with transparent pricing. Medicare Advantage plans often lack data and compliance information, while payment rates are manipulated based on a complex "risk modeling" process.
The Center for Economic and Policy Research reports: Even as Medicare Advantage insurers' profits are inflated, quality of patient care is reduced.
The United States remains an outlier—the only developed nation lacking universal healthcare, the only nation that places profiteering middlemen between patients and their doctors.
Since Reagan, continual huge tax cuts for wealthy corporatists have spiked national deficits, paid for with deficit-cutting on the backs of working people by cutting public and social programs. The 2025 Republican reconciliation bill promotes enormous tax cuts for the wealthy, and huge cuts to Medicaid and SNAP programs.
Were House Republicans serious about cutting "waste, fraud, and abuse," instead of cutting Medicaid coverage for 8.7 million people, they would eliminate Medicare Advantage scams that bleed $140 billion in annual overpayments from the Medicare Trust Fund—invested in as a lifetime earned benefit by every U.S. worker. Fraudulent "upcoding" exaggerates patient health conditions, costing $23 billion in 2023 overpayments. Some Medicare Advantage plans employ AI or a computer algorithm to instantly deny payments—reportedly used by Cigna to deny over 300,000 requests for payments in 2022.
Rigged to maximize government overpayments to pad shareholder and CEO profits—ultimately to privatize Original Medicare—Medicare Advantage overpayments are funded by taxpayers and Medicare Advantage and Traditional Medicare enrollees, who pay, among other costs, increasing Medicare Part B premiums annually—totaling $13 billion higher premiums in 2024.
A physician-authored report advises: "The time has come to declare Medicare Advantage a failed experiment and abolish it." Taxpayer overpayments to Medicare Advantage should instead go to boost an economy and healthcare for the people by eliminating profit-maximizing insurance middlemen. At least 22 studies report annual $600 billion Medicare for All administrative savings, enough to extend comprehensive health coverage to all ages.
A 2018 economic analysis by UMass Amherst Economists concluded that Medicare for All would significantly improve healthcare outcomes, and reduce healthcare spending by nearly 10%—from approximately $3.24 trillion to approximately $2.93 trillion. Additional projected annual prescription drug savings total $200-$300 billion.
Washington Complicity in Half-Century Privatization of Medicare
Further boosting privatization of Medicare, the Centers for Medicare and Medicaid Services' (CMS) "innovative payment" experiments, modeled on "Managed Care" Accountable Care Organizations, were written into the Affordable Care Act. The Congressional Budget Office reported in 2023 that CMS experiments with "value-based" ACO payments failed to control costs, improve quality, or increase equity, costing Medicare $5.4 billion more than it saved during its first decade.
Medicare for All Would Vitalize an Economy for the People
The United States remains an outlier—the only developed nation lacking universal healthcare, the only nation that places profiteering middlemen between patients and their doctors. U.S. healthcare spending since 1980 outpaces other nations, and demonstrates "by far the worst overall health performance."
Only Single-Risk-Pool Medicare for All can leverage cost-savings of global health budgets to achieve financially sustainable, universal, comprehensive healthcare, while greatly reducing the 30% administrative costs of thousands of fragmented Medicare Advantage plans. The newly introduced Medicare for All Act of 2025 would eliminates out-of-pocket costs—premiums, copays, and deductibles—and unnecessary supplemental plans—Medicare Parts A, B, C, D, and Medigap.
For the first time in almost a century prioritization of universal health coverage would eliminate profiteering middlemen, boosting an economy that serves working people—not the ballooning billionaire kleptocracy.
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Progressives Mark Mother's Day With Calls to 'Honor Our Moms With Action'
"Today on Mother's Day, let's remember every mother deserves a livable wage, affordable childcare, paid family leave, and the ability to retire with dignity," said Sen. Bernie Sanders.
May 11, 2025
As the Republicans who narrowly control both chambers of Congress plot cuts to programs that serve the working-class to pay for tax giveaways to the wealthy, progressive lawmakers on Sunday marked Mother's Day by renewing calls for policies that would improve the lives of U.S. families.
Congresswoman Rashida Tlaib (D-Mich.), founder of the Congressional Mamas' Caucus, said in a video shared to social media that "this Mother's Day, we're gonna fight to protect Medicaid, we're gonna fight for childcare, and we're gonna fight to make sure that our children have access to clean water."
Other representatives featured in the video also pledged to fight for federal programs, including Medicaid, which provides health coverage to low-income individuals; Head Start, which provides early childhood education and programming for working-class parents; and Supplemental Nutrition Assistance Program (SNAP), commonly called food stamps.
President Donald Trump's administration recently reversed course on Head Start cuts by leaving them out of the proposed fiscal year 2026 budget—at least for now—but, as USA Todaynoted earlier this month, "other preschool and after-school programs may be in jeopardy as the Republican-controlled Congress wrestles over the federal budget this summer."
As part of that budget battle, GOP lawmakers are targeting programs including SNAP and Medicaid. In a U.S. House of Representatives floor speech, Tlaib declared that "too often, mothers are left behind in this chamber."
"In the richest country in the world," the mother-of-two argued, "no mother should worry about feeding her children or affording basic care. Ending child poverty is a policy choice. I introduced the End Child Poverty Act to provide universal child benefit for every child in our country and cut child poverty by 60%. Paid leave, affordable childcare, and universal school meals should be guaranteed, not privileges."
Tlaib also noted the Black Maternal Health Caucus' Momnibus Act, a bill she co-sponsors that aims to address the nation's maternal health crisis, and a new Mamas' Caucus campaign to battle GOP efforts to cut hundreds of billions of dollars from Medicaid. She said that "this Mother's Day, I'm asking all of you to not only thank our mothers, but do it with action as we recommit to fighting for the dignity and health of every mother in our nation."
Like Tlaib, Rep. Jonathan Jackson (D-Ill.) used Mother's Day to recognize the U.S. maternal health crisis.
"As we honor our mothers, we must also recognize that too many are being failed by a system that should protect them," he said on social media. "In the U.S., Black women are nearly three times more likely to die from pregnancy-related complications than white women, regardless of income or education. The U.S. has the highest maternal mortality rate among developed countries. Over 80% of pregnancy-related deaths in the U.S. are preventable. This is unacceptable."
"We will continue fighting for mothers today, tomorrow, and every day for their right to safe, dignified care, bodily autonomy, compassionate treatment, and healthy equity in America," Jackson added.
Rep. Ro Khanna (D-Calif.) on Sunday advocated for his Child Care for America Act, which aims to make childcare $10 per day for families but raise the pay floor for industry workers to $24 an hour.
Khanna, Jackson, and Tlaib have all backed the fight for Medicare for All—and the related bill for that was reintroduced late last month by Sen. Bernie Sanders (I-Vt.) and Reps. Debbie Dingell (D-Mich.) and Pramila Jayapal (D-Wash.).
"Today on Mother's Day, let's remember every mother deserves a livable wage, affordable childcare, paid family leave, and the ability to retire with dignity," Sanders said Sunday. "America must become a nation which treats all mothers and their kids with the respect and dignity they deserve."
Sen. Elizabeth Warren (D-Mass.) honored her own mom on Mother's Day by resharing, in a series of social media posts, the story about how she supported their family by securing a minimum wage job.
"After my daddy had a heart attack, he couldn't work for a while. Bills piled up. We lost our family station wagon. It looked like the house would be next to go. At night, I'd overhear my parents talk, and that's when I learned words like 'mortgage' and 'foreclosure,'" she recalled. "One day, I walked into my parents' bedroom. My mother's face was red and puffy. A dress was laid out over the bedspread—the dress that only came out for weddings, graduations, and funerals."
"'We are not going to lose this house,' she kept saying. 'We are not going to lose this house.' She'd never worked outside the home. She was terrified," Warren continued. "But she knew what she had to do. I watched her put that dress on, put on her high heels, and blow her nose. She walked to Sears. She got a minimum wage job. And that minimum wage job saved our house and saved our family."
"Today, the federal minimum wage is $7.25 per hour—a wage that has not increased in over 15 years. With that, a family living on minimum wage is living in poverty."
The senator said that "this story is written on my heart. I'm remembering my mother's courage this Mother's Day. I'm thinking about all the mamas out there fighting for their families. And I'm thinking about all the ways the deck is stacked against mothers and families today. A mother today would not be able to work a minimum wage job and keep everyone afloat. Today, the federal minimum wage is $7.25 per hour—a wage that has not increased in over 15 years. With that, a family living on minimum wage is living in poverty."
"And, without quality, affordable childcare, mothers have been shoved out of the workforce," she noted. "They will feel the consequences—in lost earnings, in lower Social Security benefits—for the rest of their lives. And, notably, most women who get abortions today are already mothers. Many are working multiple jobs that don't pay enough to support their children. Abortion bans make it even harder for those families to make ends meet."
While GOP policymakers are working to restrict reproductive freedom and cut safety net programs, Warren made her priorities clear: "I'm working to give every mother and every family a fighting chance—and I'm in this fight all the way."
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