As congressional Republicans debate whether to approve measures that would slightly reduce the rate of growth in Medicaid, experts say the most effective way to prevent government dependence involves following a biblical precept: avoid having children outside wedlock.

A new study finds a near one-to-one ratio in welfare use and the ability to follow the three steps Brookings Institution researchers Isabel Sawhill and Ron Haskins identified as “The Success Sequence”: graduate high school, get married before having a baby, and work (or marry someone who works) a full-time job.

“As matters stand now, most teen and unmarried births in the U.S. wind up being subsidized by taxpayer dollars,” found Nicholas Zill, a research psychologist and a senior fellow of the Institute for Family Studies (IFS). In a newly published survey, Zill correlated demographic data about mothers with payment records for their child’s birth, culled from the National Vital Statistics Reports released on March 18. Then Zill added one additional requirement to the sequence: that a mother wait until at least the age of 20 to give birth.

He found that “for every 10 percentage-point increase in the extent to which parents in an ethnic group stuck to the [Success Sequence] pathway, there was an 8.4 percentage-point increase in non-reliance on welfare for payment of a baby’s delivery.”

Only 45% of babies born in America had mothers who had completed all the steps of the Success Sequence, he found. But the percentage varied widely across demographic groups. Three-quarters (76%) of Asian-Americans and nearly two-thirds (62%) of white babies were born to couples who completed all the steps of the Success Sequence. Less than one-third of Hispanics and one in seven (15%) black children were born in similar circumstances. At the same time, “75% of Asian births and 69% of White births were paid for by private dollars, whereas the same was true for only 33% of Black births and 38% of Hispanic births.”

“A straight-line relationship between success sequence adherence and welfare independence accounted for 94% of the variation across ethnic groups in welfare non-reliance,” wrote Zill.

The IFS did not immediately respond to The Washington Stand’s query about what percentage of Medicaid use can be directly attributed to out-of-wedlock births. But the report stated, “The major factor driving the ethnic variation in Success Sequence babies was marriage.”

Richard V. Reeves, a colleague of Sawhill and Haskins at the Brookings Institution and president of the American Institute for Boys and Men, found, “if blacks followed the success sequence they were just as likely as whites to become middle class.”

The benefits accrue to members of all ethnic groups. Young people who observe all three measures “have a 97% chance of avoiding poverty as they move into adulthood” and are “significantly less likely to experience family breakdown and emotional distress as adults,” said Brad Wilcox, a professor of sociology at the University of Virginia.

National leaders have long known of the benefits brought to those who follow the three-prong life plan. Then-Senator and two-time presidential hopeful Rick Santorum popularized the Success Sequence in the 2012 Republican primaries. It would be repeated in the next election cycle by then-Senator and current Secretary of State Marco Rubio.

Legislators hope teaching the practical benefits of godly morality will reduce teen births, ease the public rolls, and launch young people on the road to prosperity. Ohio’s S.B. 156, sponsored by state Senator Al Cutrona (R-33), would direct the Ohio Department of Education to “develop standards and a model curriculum about the success sequence for grades six to twelve, which shall include evidence, identified using the best research methods available, describing the positive personal and societal outcomes associated with the success sequence. … Each school district board of education shall provide instruction on the success sequence.” The Center for Christian Virtue, based in Columbus, champions the bill.

Separate studies have found that Medicaid use often saps another pillar of life satisfaction and poverty reduction: work. By some measures, maintaining a full-time job alone accounts for nearly all of the sequence’s poverty reduction. “A nationwide study of able-bodied adult ObamaCare expansion enrollees in Medicaid showed that 55 percent did not work at all. Worse still, nearly 75 percent of prime working-age able-bodied adults collecting food stamps reported no work. Less than three percent of these individuals reported working full time,” wrote Michael Greibrok, a senior research fellow at the Foundation for Government Accountability (FGA).

Expanded work requirements “would save taxpayers more than $175 billion over the next decade, moving millions of able-bodied adults back to work and providing a much-needed boost to the economy,” the FGA found. It would also benefit families. Within a year, the incomes of those who entered work doubled; within two years, they tripled, more than compensating for any lost public benefits.

Experts say requirements that work-capable Medicaid recipients engage in some form of employment, as currently contemplated by the Trump administration, help all society. “Requiring able-bodied individuals to work or look for work is not a new concept. Conditioning work in exchange for receiving other welfare benefits were a key part of welfare reform in the 1990s. Work requirements are a way to promote a pathway out of poverty and improving their overall well-being,” Nina Owcharenko Schaeffer, director of the Center for Health and Welfare Policy at the Heritage Foundation, told The Washington Stand.

“Welfare programs with work requirements have positive effects on recipients and society,” found a Heritage study. Thanks to work-based entitlement reforms, “some 9 million additional children now live in married, rather single-parent, families.” Moreover, work improved the lives of those who transitioned from government dependence to work. “When mothers who were formerly dependent on welfare find employment, we see increased physical health, as well as emotional and psychological health. There are even better educational outcomes, as well as improved health and behavioral well-being for their children,” it stated.

“Work requirements, for instance, are essential to reducing welfare dependency. When individuals are encouraged to contribute to society through meaningful work, they regain a sense of dignity and self-worth — key elements for the stability and strength of the family unit,” agreed Vance Ginn, president of Ginn Economic Consulting and the author of the new book “Empower Patients” with Dr. Deane Waldman. “Block grants, eligibility checks, and work requirements are essential first steps” to Medicaid reform, Ginn told TWS.

The issue became a sticking point in the most recent round of budget talks, in which experts have highlighted numerous ways lawmakers can cut Medicaid’s cost without reducing services, such as eliminating intergovernmental transfers (IGT), which analysts have likened to “money laundering.”

But the workforce could also use an injection of fresh labor. The U.S. labor market had 7.4 million unfilled jobs in April, according to the U.S. Bureau of Labor Statistics. “We have [more than] seven million healthy American men of working age who aren’t working right now. Let’s do them a favor: Let’s help them get a job. The best safety net out there is a job,” Senator Roger Marshall (R-Kan.) told “Washington Watch” on Thursday. “It’s good for your mental health. It brings purpose to your life.”

The labor participation rate is 62.1%, down nearly 7% in the last 20 years. The labor participation rate has been above that level with only two exceptions since October 1977. The decline in work rate has been steeper among men than women, and among whites than blacks. Some 21 million Americans of prime work age (25 to 54) are not currently in the workforce — 19 million of whom say they do not want a job. Only 483,000 Americans in their peak working years say they are jobless because of disability or health issues (67,000), family responsibilities (89,000), schooling (28,000), or other necessities.

“Our Christian duty is to take care of those who are the least amongst us, and I will guarantee you that I will do everything I can to protect Medicaid for those who need it the most,” including children and the disabled, said Marshall. “We want to do our godly duty and give people a hand up, not a hand out.” 

Nearly three-quarters (72%) of Americans say work-capable Medicaid recipients should be required “to at least look for work or participate in community service part-time in order to keep their Medicaid benefits,” found a poll from Fabrizio, Lee, and Associates, a Republican-aligned polling firm.

The proposal should enjoy bipartisan support. “We should insist that people move off welfare rolls and onto work rolls. We should give people on welfare the skills they need to succeed … and become a productive member of society,” declared future President Bill Clinton in 1991 as he announced his first presidential campaign. Clinton also wanted to see society crack down on deadbeat dads by demanding the “toughest possible child support enforcement.”

“Governments don’t raise children,” said President Clinton. “Parents do.”