A number of states are already taking advantage of a new federal rule allowing them to implement work requirements for Medicaid coverage. Roll Call reports:

At least four non-expansion states, including Mississippi and Kansas, have already submitted formal work requirement proposals to the Department of Health and Human Services. They are among at least 10 states, including Indiana and Arkansas, to do so. The administration has only approved one proposal so far—in Kentucky, a state that expanded the government insurance program for the poor under the health law.

A familiar reasoning underpins the argument for work requirements: People are poor because they don’t work. But most Medicaid recipients do work either full-time or part-time jobs; the rest, according to the Kaiser Family Foundation, work as unpaid family caregivers or go to school. Only 7 percent of all Medicaid recipients are out of work for unknown reasons—and in depressed areas, those reasons could easily include a scarcity of local work.

The policy could directly backfire: People are healthier when they have access to health insurance, which means they’re better able to work. People recovering from opioid addiction could lose treatments covered by Medicaid. Work requirements, therefore, will push people further into poverty, and there will be dangerous ripple effects. Since a number of Medicaid recipients work as family caregivers, elderly people and people with disabilities could lose an important source of caregiving support. It’s a punitive policy with no real positive benefit—unless your goal is to make poverty seem like a pathology.