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On drug tests for Medicaid applicants

Fourteen states now have some type of drug screening or test as part of their public benefits programs, according to the National Conference of State Legislatures. The majority of these screenings target recipients of Temporary Assistance for Needy Families, a federal program that gives states more leeway over the screening of applicants.

Gov. Scott Walker now wants to make Wisconsin the first state in the country to require childless adults applying for Medicaid to undergo drug screening, a move that could serve as a national model. Walker’s plan, which would need federal approval, is touted as a way to make welfare programs a “trampoline, not a hammock” to get people back into the workforce.

Jon Peacock, research director of the Wisconsin Council on Children and Families, sees it another way.

“It would be an extremely negative development because it treats drug addiction as a moral failing rather than a disease,” Peacock said. “It says that we’re going to test people first as a condition of getting access to health care, which is backwards. We need to get people into health care programs, build trust with their doctors and then get them the treatment they need.”

According to the Associated Press, the new drug test requirement would affect about 148,000 of the 1.2 million people in BadgerCare, Wisconsin’s main Medicaid program. BadgerCare provides benefits to people who earn less than $12,060 a year as a single adult and $16,240 a year for a couple.

Under Walker’s plan, those who refuse a drug test would be ineligible for coverage until the test is completed, while people who test positive would get treatment paid for by taxpayers through the Medicaid program.

Details about the type of treatment and where it would be offered would be worked out with the federal government as the plan goes forward. Those who refuse treatment would lose benefits for six months.

Drug testing as a requirement for public benefits has several pros and cons.

On the plus side, the testing of recipients can help identify individuals in need of substance abuse treatment. It can also discourage long-term dependence on welfare.

Most importantly, there is already a precedent for drug testing in the job market. In some cases, refusing a drug test means you won’t get hired.

Opponents of drug testing argue that any savings from the program will be outweighed by the cost of the testing. Historically, the percentage of welfare applicants testing positive has been very low. Those who disapprove of drug testing also stress its intrusion on privacy and the accompanying stigma.

Perhaps the most interesting question is this: If drug testing is a sound policy, why limit it to Medicaid applicants? In Wisconsin’s case, if drug testing makes fiscal sense, shouldn’t anyone whose medical insurance is at least partially paid by taxpayers be tested for drugs?

It’s a valid question, though admittedly not as politically popular as Walker’s proposal may be.

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