The One Big Beautiful Bill Act (OBBBA) that was recently signed into law by the current incumbent in the White House has within its hundreds of provisions a number of cuts to Medicaid funding under the pretext that there’s vast and widespread fraud and cheating going on. One of the ways Republicans (and it was only Republicans that voted for the bill) have chosen to made those cuts is through the implementation of a work requirement for some Medicaid beneficiaries.
An official line posted on the White House website posits that “The 20-hour weekly work requirement applies only to able-bodied adults without young children and promotes dignity, stability, and better health outcomes for families. The One Big Beautiful Bill restores the dignity of work with historically bipartisan work requirements for able-bodied Americans. We are implementing commonsense, Clinton-era work, volunteer, education, or training requirements with broad bipartisan support.” It seemingly hopes to assuage the reader with a reference to a more popular president.
The work requirement does indeed only apply to those adults mentioned in the statement but beyond that there’s no truth to be had. Mike Johnson, the speaker of the house, was rather more candid when he stated in an interview on CBS that he feels that those who are able-bodied are cheating the system by not working. The work requirement will apparently make them get off their arses so they can be sure of receiving healthcare services when they need them.
The truth is that most of the able bodied adults on Medicaid are working but in jobs that provide no health insurance and pay so little that they meet the income requirements for this needs based program. Research by the Kaiser Family Foundation showed that 64% of ABAWDs (Able-Bodied Adults without Dependents) are actually working, a significant percentage have caretaking roles and only 8% might fit the category that the bill is aiming at hurting.
Those who dreamed up the idea know that the rosters will be reduced not by getting rid of spongers but by tangling up in red tape otherwise eligible recipients. ABAWDs are going to be obliged to report their work activity or explaining why they didn’t meet the requirement. Despite the constant harping by Republicans of their hatred of government bureaucracy they are actually setting up a nationwide Byzantine empire of red tape, all designed to frustrate poor workers to the point of giving up.
It’s also worth noting that all that extra paperwork will cost money. A 2019 study by the Government Accountability Office showed that states that had set up their own work requirement systems had paid $463 a person to do so.
The rule goes into effect in January 2027.