The New York Times op-ed page gives space to some of the worst arguments ever made, so it’s unsurprising to find anti-vaccine crank Robert F. Kennedy Jr. (net worth: $30 million) and TV huckster Dr. Oz (net worth: $200 million) joining forces to argue in the Times that we should strip poor people of their healthcare benefits. The op-ed is also co-authored by Secretary of Agriculture Brooke Rollins and Secretary of Housing and Urban Development Scott Turner.

Kennedy et al. argue that many poor people in this country are being coddled. They are getting free food and healthcare without holding jobs. The writers argue that these lazy poor people should have their benefits taken away unless they can prove that they are gainfully employed. They argue: 

America’s welfare programs were created with a noble purpose: to help those who needed them most. [...] In recent years, though, these welfare programs have deviated from their original mission both by drift and by design. Millions of able-bodied adults have been added to the rolls in the past decade, primarily as a result of Medicaid expansion. Many of these recipients are working-age individuals without children who might remain on welfare for years. Some of them do not work at all or they work inconsistently throughout the year. The increased share of welfare spending dedicated to able-bodied working-age adults distracts from what should be the focus of these programs: the truly needy. This should not be the American way of welfare. That’s why we are joining efforts to require able-bodied adults (defined as adults who have not been certified as physically or mentally unfit to work), with some exceptions, to get jobs….

Kennedy et al. do not dispute that the people who are getting Medicaid are poor. Their problem is that these are the undeserving poor, who should not get healthcare provided by the government, because they are choosing not to work. Kennedy et al. says this thinking should apply to all “welfare” benefits, including “the Supplemental Nutrition Assistance Program, Medicaid and federal housing assistance, among others.” Work, they say, creates “purpose and dignity,” and “welfare should be a short-term hand-up, not a lifetime handout.” 

The idea that there is a vast class of spongers living high on the hog by claiming Medicaid is false. As Matt Bruenig notes in another Times op-ed completely demolishing the premises of Kennedy et al., “Medicaid work requirements are a solution to a problem that doesn’t exist.” Bruenig notes that the number of working-age Medicaid enrollees who are not engaged in work long-term comprise “just 3 percent of the entire Medicaid population.” Indeed, the U.S. Department of Health and Human Services (HHS) itself—pre-RFK—has noted that “among enrollees who aren’t already working, nearly all have disabilities, serious health conditions, childcare or caretaking responsibilities, or are in school.”

To deal with the small percentage of the population (whose circumstances we do not actually know, and which Kennedy et al. make no attempt to discover) who are receiving a basic level of healthcare without giving labor back in return, Kennedy et al. want to impose a burdensome bureaucratic requirement. Instead of just giving people healthcare, the government must also continuously monitor their employment status. That means paperwork, which means administrative expense, and new paperwork requirements mean that plenty of people who are entitled to benefits are not going to get them simply because they haven’t filled out the proper forms, or there’s an error on the forms, or the forms haven’t been processed correctly. As HHS pointed out, “only one state has ever fully implemented these [work requirement] policies, and nearly 1 in 4 adults subject to the policy lost their health coverage—including working people and people with serious health conditions—with no evidence of increased employment.” 

So plenty of eligible people will lose coverage, it’ll be a big bureaucratic pain in the ass, and it probably won’t actually get those people to work. In fact, taking away someone’s healthcare may make it harder for them to get a job, because as Bruenig notes “an unemployed person with an untreated broken bone becomes less employable, not more.” This is clearly about a principle. RFK Jr., Oz, and the other Trump administration officials don’t even try to prove that taking Medicaid away from people will benefit them. Here’s how they respond to the argument that they’re putting an unnecessary barrier between people and healthcare: 

“Some will argue that work requirements create barriers to resources. We disagree. We believe that welfare dependency, not work, is the barrier.”

We disagree! That’s all they say! Critics argue that the administrative barriers are going to kick eligible people off Medicaid, and all they can say is “We disagree.” Where’s the argument? Where’s the evidence? Honestly, I knew that the NYT op-ed page had pretty low standards. (They just let Thomas Friedman get away with saying that “this is the first government in Israel’s history whose priority is not peace with more of its Arab neighbors,” a massive whopper that should have made the fact-checkers’ eyes pop out of their heads). But surely an editor should have noted that “we disagree” is not a sufficient response to the claim they’re criticizing, and “we believe” is not a substitute for evidence.

So if they’re not providing proof that this policy is going to actually help anyone, what is the principle here? It appears to be that people shouldn’t get something for nothing, even if that something is a visit to the doctor. But as Bruenig points out, we don’t apply that principle in the case of fire services, police, schools, and roads. He observes correctly that we could only put out fires in houses of people who have employment certificates, but this would not just be administratively burdensome but also morally heinous. Why should a basic level of healthcare be conditional on employment?

Kennedy et al. shouldn’t even be referring to Medicaid as “welfare.” Protection by your local fire department isn’t welfare, and ambulance services aren’t either. We shouldn’t even be thinking about the question of whether people have earned their Medicaid. A functioning society should take care of everybody, both because it’s the right thing to do and because it is in nobody’s interest to have sick people going untreated. When we say “healthcare is a human right,” we mean that it’s not subject to means testing, it’s not subject to moral testing, it’s something you should be given because you are a human being, period. You do not have to earn your right to healthcare.

We should be moving in the direction of expanding, not diminishing, the provision of health services to the poor. We need a system more like the British NHS: free at point of use, available to all. We should not let multi-millionaires convince us that there is something excessively generous about ensuring that people’s most basic needs are met regardless of their work status. Healthcare is a human right, period, which means that any attempt to take Medicaid away from anyone is an assault on the basic rights of the American people.