[Congressional Record Volume 163, Number 85 (Wednesday, May 17, 2017)]
[Senate]
[Pages S3012-S3013]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]

      By Mr. KENNEDY:
  S. 1150. A bill to amend title XIX of the Social Security Act to 
require States to impose a work requirement for able-bodied adults 
without dependents who are eligible for medical assistance; to the 
Committee on Finance.
  Mr. KENNEDY. Mr. President, I would like to talk today about the need 
for a work requirement in our Medicaid Program. In 1969, President 
Lyndon Johnson addressed the American people, and he talked about 
breaking the cycle of poverty. This is what President Johnson said:

       I believe . . . that the key to success in this effort is 
     jobs. It is work for people who want to work.

  President Johnson, as we know, was a Democrat. He fervently believed 
that the people of Louisiana didn't want handouts. Most people want a 
chance to support themselves. President Johnson also believed that 
Medicaid, as originally envisioned, would be a safety net for the 
disabled, the elderly, and people with small children. Medicaid is not 
exactly that; it is dramatically different.
  Whether you agree or disagree with what has happened to Medicaid, the 
fact is that it has turned into a health insurance program for about 20 
percent of all Americans. Think about that. We have roughly 320 million 
people in our country, and fully 25 percent are on Medicaid. It gets 
bigger and bigger every year, and it gets more expensive every year. 
You can see that the numbers speak for themselves. You can see the 
trend. You can certainly see that we started in 1966, and you can 
particularly see the trend beginning in 1996 and its trajectory.
  It also became more expensive. The cost of our Medicaid Program in 
1966 was $1 billion. That is a lot of money. This is the cost of last 
year: $576 billion and climbing.
  Let me talk about our State alone. In Louisiana, the cost of Medicaid 
has increased from $5.9 billion in 2008 to $10.7 billion today, and 65 
percent of all of the babies born in Louisiana every year now are born 
on Medicaid. Think about that.

[[Page S3013]]

  We know that Medicaid is a Federal-State program. The Federal 
Government puts up some of the money; the State puts up some of the 
money, as well. In Louisiana, we put up about one-third of the money. 
In Louisiana dollars, in 2008, we were putting up $1.7 billion in State 
money. It is called the match for the Medicaid Program. Today, the 
State of Louisiana is paying $3.3 billion. You can do the math. That is 
about a 10 percent increase every year.
  If we are spending $3.3 billion of State money, that means every 
year, just like clockwork, we have to come up with an extra $330 
million. I can tell you where that money comes from. It comes out of 
public schools, it comes out of universities, it comes out of our 
budget for roads, and it comes out of our budget for public safety.
  We have a choice in America. Either Medicaid is going to be, as we 
originally envisioned it, a safety net for the old, the disabled, and 
mothers with babies or it is going to be a health insurance program for 
the masses.
  If the American people and Congress decide that Medicaid is going to 
be a health insurance program for the general population, then it needs 
to operate as health insurance does in the private sector. In other 
words, able-bodied adult enrollees in Medicaid should be required to 
work in order to receive their benefits, if they are able.
  I am filing a bill that is going to be entitled the ``Medicaid Reform 
and Personal Responsibility Act of 2017.'' It is going to create a work 
requirement for Medicaid. My reason is simple. I want Americans to 
prosper. I don't want our people to remain mired in poverty. I want to 
break poverty's back by creating a system that doesn't force the 
American people to subsist on handouts from government, and the best 
way to do that is to provide an incentive for able-bodied Americans to 
know the dignity of work because a person without a job is neither 
happy, nor is he free.
  I think my bill is a commonsense approach to reducing America's 
reliance on entitlement programs. The work requirement will be very 
simple. It will be similar to the program that we have in place--the 
work requirement we have in place right now for food stamps.
  This is what my bill would require: If you are on Medicaid or want to 
receive Medicaid, and you are an adult between the ages of 18 and 55, 
and you are able-bodied, you are not disabled, and you don't have any 
dependents, you don't have any children--so if you are 18 to 55, you 
are not disabled, and you don't have any children, then in order to 
receive Medicaid or to continue to receive Medicaid, you have to either 
work 20 hours a week--not 40 hours a week but 20 hours a week--you have 
to look for a job or you have to go back to school if you don't want to 
work. Or if you don't want to go back to school or you don't want to 
look for a job or you don't want to get a job, you have to perform 
community service for 20 hours a week. My goal is to get people off 
Medicaid and into the workforce, so they can support themselves and not 
need Medicaid.
  I don't want to take Medicaid away from people in need. I do want 
fewer people to need Medicaid. So if you are disabled, if you are 
pregnant, if you are elderly, if you are caring for a child, my bill 
doesn't apply to you. I am not talking about telling a mother with a 
baby in her arms that she has to go find a job, and I am not going to 
ask an elderly person in a nursing home to leave the nursing home and 
go get a job in order to receive Medicaid. All my bill says is that if 
you are young by today's standards, between 18 and 55, you are able-
bodied and you have no children or dependents, then you have to go get 
a job or you have to go to school or you have to perform community 
service.
  I want to be very clear about something else. In my State, we have a 
lot of flood victims. We had terrible flooding last year. In my State, 
Louisiana, we have a depression in the oil and gas industry; indeed, we 
do throughout America, and I know we do in the great State of Alaska as 
well. I am not looking to add to their hurt. I am working very hard, as 
are you, Mr. President, to put our oilfield workers back to work and to 
get our flood victims the assistance they need to recover from the 
tragedy that has befallen them. This bill is not about them. This bill 
is about able-bodied adults between the ages of 18 and 55 who have no 
dependents and who have been unemployed for years, in many cases, by 
their own choosing.
  Our country has grown a lot and evolved a lot since Medicaid was 
introduced in 1965. We now face new challenges, both at home and 
abroad. We know that. Medicaid has grown, as well, but it hasn't 
evolved in a positive way, in my opinion. Just 3 years after Medicaid 
was founded, we knew we were going to have a problem finding the money, 
given the exponential growth in the program, and more than 50 years 
later, it is way past time to do something about it.
  We have to break the back of poverty. This is not about throwing 
people out into the cold. This is about helping them to know that they 
can get work because the best program--the best social program in the 
entire world is a job. By implementing a work requirement for able-
bodied adults, Medicaid will evolve to the next logical step. Our goal 
ought to be to ensure, of course, that people are healthy. That is what 
Medicaid exists for, but if you are healthy, then the next step is to 
help you join the workforce.

  The simple fact is, this is nothing new or extraordinary. We already 
have work requirements--required by acts of this Congress--for 
unemployment assistance, for welfare benefits, for subsidized housing, 
and for food stamps. Now, these requirements have been a success. We 
all know that, not just for stemming the costs of those programs but 
also for helping people--helping Americans build careers.
  Yet we do not have a requirement--a work requirement--for Medicaid. 
If my bill passes, we will. Work requirements exist because these 
programs are supposed to be safety nets. That is what a social program 
is, a safety net. They are not supposed to exist to permanently support 
you if you can support yourself.
  Our social programs in America are meant to be bridges. In way too 
many respects, they have become parking lots. Medicaid costs are not 
just a national problem. The program's expansion is clipping the wings 
of States like Louisiana and like Alaska because, as I pointed out, the 
States have to put up a substantial amount of the money.
  We are becoming a country in which people subsist instead of thrive 
because they don't know the rewards of work. We have become a country 
in which poverty is a way of life for way too many people. That is just 
sad. More than 50 years after Medicaid began, it is time to break the 
back of poverty once and for all. We can start with a work requirement 
for Medicaid.
  Thank you.
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