Alfonse D'Amato

A good job is the best medicine


When Medicare and Medicaid were created in the 1960s, they received strong support in Congress from both parties. Then, in the 1990s, a bipartisan coalition added the Children’s Health Insurance Program to the nation’s health care safety net. (I was one of the senators who voted for it.)

Unfortunately, when Congress passed Obamacare in 2009, it was enacted strictly along party lines, with the Democratic majority shutting out the Republican minority from any meaningful input.

Today, these political fault lines still keep the parties far apart on many aspects of health care policy. But there are some things that shouldn’t be debated. Recently, the Trump administration announced a new policy allowing states the flexibility to require able-bodied adults who receive Medicaid benefits to enroll in work training and education courses. Can there really be any question about encouraging those who can work to prepare themselves for today’s jobs?

We are fast approaching a full-employment economy, in which jobs will go unfilled unless people currently not seeking work do so. Already, many jobs requiring various skills go begging, with too few Americans adequately trained to fill them. And jobs today are getting better, with higher pay. Minimum wages are on the rise, and starting pay is moving higher, too. Ask the 1.5 million Walmart employees who just got a $2 an hour raise — equal to $80 more per week and $4,000 more per year — and $1,000 bonuses if that extra cash in their pockets isn’t a big deal for them. Millionaires like House Minority Leader Nancy Pelosi may say that’s only “crumbs,” but to working Americans, money like that is a very big deal.

All this should encourage our national leaders to cheer for America’s workers and encourage them to help grow our economy. Every increase in national productivity and economic activity creates more jobs and more upward mobility for all Americans. That’s why unemployment among African-Americans — who were hit hardest by the 2007-09 recession — is now at historic lows. But that’s not good enough. Young blacks are still under-employed, often saddled with poor education and few job skills. It’s time we focused more attention on getting them the skills for today’s employment opportunities.

Which brings me back to the administration’s policy to grant states the authority to require job training as a condition for receiving Medicaid benefits. Some out-of-touch critics may not appreciate just how important a job can be to one’s self-worth and dignity. But if a young person can get a decent job, see his or her wages and bonuses climb steadily, have good benefits like health care and look forward to moving up the economic ladder, how can that not be good?

Today, the safety net for American workers is stronger than ever. Along with Medicaid and CHIP benefits, working families can receive direct assistance under the earned income tax credit, can still qualify for assistance under the food stamp program and are often eligible for housing assistance. But the best safety net is a good-paying job that makes for a productive life and turns people into contributing members of the American economy.

In the next few years, Washington will have to face the growing pressure on the federal budget from social programs like Medicare and Social Security that could threaten benefits for future generations. Hard choices will have to be made about raising the age at which we become eligible for these programs. Members of the next generation will likely have to work longer to qualify for their benefits, which is all the more reason their employment opportunities and incomes must expand. As America’s workforce grows into the 21st century economy, let’s encourage an economy that grows, too.

And in New York, let’s do more to keep our kids and grandkids here, rather than losing them to lower-taxed states with greater job opportunities. I talk with too many Long Island neighbors whose kids are forced to move to Atlanta or Austin or other Sunbelt cities. Let’s get our own house in order and lower the cost of state government so we don’t slip further behind sunnier climes and rosier futures elsewhere.

Al D’Amato, a former U.S. senator from New York, is the founder of Park Strategies LLC, a public policy and business development firm. Comments about this column?