Work Requirement Will Remove Freeloaders from Medicaid

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President Donald Trump’s “big, beautiful bill,” which the House passed during the wee hours of May 22^nd, includes a work requirement for certain recipients of Medicaid benefits as well as other modest reforms of the bloated Medicaid program. Starting no later than December 31, 2026, childless, able bodied Medicaid recipients aged 19-64 must prove that they are working in a job, volunteering, or participating in a job training program for at least eighty hours per month.

Leftists are engaging in their usual disinformation campaign to scare the American people. For example, House Minority Leader Hakeem Jeffries has falsely claimed that the proposed Medicaid reforms will harm children, older Americans who rely on Medicaid for nursing home care, and disabled people. That is sheer demagoguery. The work requirement is an example of a carefully tailored reform that will both save taxpayers money and help keep Medicaid afloat for those Americans who truly need it.

Medicaid is jointly financed by both the federal government and the states, with the federal government paying the lion’s share. Beginning in 2014, the Obamacare Affordable Care Act (ACA) has provided states with the authority to expand Medicaid eligibility to individuals under age 65 in families with incomes below 133 percent of the Federal Poverty Level. Coverage for the newly eligible adults was fully funded by the federal government for three years and decreased to a still very hefty 90 percent in 2020.

Adults in the expansion group who were made newly eligible for Medicaid by the ACA’s Medicaid expansion increased from 4,214,218 in 2014 to 18,631,914 by 2024 – more than a fourfold increase in ten years.

Federal government spending on Medicaid was approximately $300 billion in 2014. Federal expenditures for Medicaid currently cost taxpayers over $600 billion. The ACA expansion has been a major driver behind this significant uptick in federal spending on Medicaid.

A study using survey data from the most recent month available (December 2022) compared the estimated share of non-disabled working age individuals without children working at least 80 hours that month who received Medicaid with those who did not. A February 2025 article by Kevin Corinth, a senior fellow and deputy director of the Center on Opportunity and Social Mobility at the American Enterprise Institute who conducted the study, discussed the highly revealing results. Mr. Corinth previously served as the staff director at the Joint Economic Committee in Congress and chief economist at the Council of Economic Advisers at the White House.

Mr. Corinth found that “44 percent of non-disabled working age Medicaid recipients without children worked at least 80 hours. For comparison, 72 percent of non-disabled working age adults without children who do not receive Medicaid worked at least 80 hours in the same month.” In short, non-disabled working age Medicaid recipients without children “work at much lower rates than non-Medicaid recipients. A work requirement focused on this population would be impactful.”

It is easy for some people to get accustomed to government handouts whether they deserve them or not. But Medicaid and other welfare programs should be preserved for the folks who truly need the safety net, not diverted to freeloaders gaming the system and draining federal resources away from helping the most vulnerable Americans.

A majority of Americans support the commonsense work requirement reform. A poll conducted earlier this year by the Paragon Health Institute, for example, found that eighty-one percent of those surveyed supported “requiring able-bodied adult Medicaid recipients to work in order for them to continue receiving Medicaid benefits.” Sixty-seven percent agreed with the following: “Medicaid should be a temporary safety net, not a long-term entitlement for those who are able to work. Encouraging this population to work would improve their personal situation and help get them off Medicaid, saving money that could be directed toward those who need it most – children, seniors, and people with disabilities.”

The big beautiful bill does not repeal the ACA’s Medicaid expansion program, nor does it place onerous new restrictions on pre- or post-ACA Medicaid eligibility criteria. But it does seek to cull out freeloaders through the work requirement, which could result in an estimated savings of $280 billion over six years.

Some critics of the work requirement attempt to mislead the public by claiming that childless adults who cannot document at least 80 hours of monthly employment will no longer qualify for Medicaid once it is put into effect. First of all, the requirement applies only to childless adults aged 19-64 who have not been certified as physically or mentally unfit to work, not to all adults without children regardless of physical or mental disability. Secondly, the requirement of “work” is not limited to actual employment. The requirement can also be satisfied by enrolling in job training or volunteering to engage in community service.

Some critics claim that the proposed reforms create too much paperwork and reporting requirements. That is another example of a ‘something for nothing’ entitlement mentality. Demanding that Medicaid recipients submit sufficient documentation to prove their fulfillment of one of the “work” options, and to verify income levels for individuals receiving Medicaid under the ACA’s Medicaid expansion, are necessary to prevent fraud, waste, and abuse.

There are also critics of the work requirement like the American Civil Liberties Union, which charged that the work requirement is “patently unjust.” Or like Matt Bruenig, the progressive founder of the leftwing People’s Policy Project, who called the work requirement “cruel.” They grossly mischaracterize a modest requirement that will incentivize people to improve themselves and become productive members of society, while at the same time saving taxpayers money and maintaining the safety net for those who truly need it.

Simply put, the big beautiful bill’s commonsense Medicaid work requirement is a win all around except for the freeloaders who are selfishly exploiting the program at the expense of the neediest.