In the hallowed halls of Congress, a deceptive performance is unfolding. House Republicans, with a seemingly innocent facade, are on a quest to slash Medicaid funding. Yet, they publicly proclaim that they have no such intentions, creating a web of misdirection. Among their various strategies, the implementation of work requirements has emerged as the favored tool in this elaborate act of political bamboozlement.
The House Energy & Commerce Committee Republicans have embarked on a mission to find $880 billion in cuts to programs under their jurisdiction, which includes crucial social safety nets like Medicare, Medicaid, and the Child Health Insurance Program (CHIP). As they strive to piece together a reconciliation package, a significant conundrum looms. For months, congressional Republicans have been adamant about not touching Medicare. This leaves Medicaid as the prime target for their budget – slashing ambitions. A report from the Congressional Budget Office in March made it clear that without cuts to Medicaid, the House’s budget resolution goals would remain unachievable. This program provides health coverage to over 70 million low – income and disabled Americans, making the potential impact of these cuts truly staggering.
Republicans have explored several ways to cut Medicaid costs, all while effectively gutting the program as we know it. Aware of the unpopularity of direct cuts back home, vulnerable House Republicans have been quick to distance themselves from options like reducing federal funding for Medicaid expansion coverage or implementing per capita caps. However, there is one option that has united even the most performatively anti – cut Republicans: Medicaid work requirements.
Sen. Josh Hawley (R – MO) was quick to voice his support, stating, “I’m all for work requirements.” When questioned about exceptions, he remained non – committal, saying he needed to see a specific proposal but was generally in favor. Hawley has been insisting for weeks that he won’t support cuts that would harm working people or those he deems qualified. But he, like many of his Republican colleagues, seems to view work requirements as a separate issue from slashing the program that so many in his state rely on. Rep. Don Bacon (R – NE) echoed similar sentiments, suggesting that able – bodied adults without children should seek better jobs or skills.
The push for Medicaid work requirements is not a new phenomenon among Republican lawmakers. It has been a recurring theme for decades. However, the reality is far from what they claim. Implementing work requirements would lead to significant cuts in the program, as eligible individuals would lose their healthcare coverage. As Energy & Commerce Committee Ranking Member Frank Pallone (D – NJ) pointed out, “Republicans’ so – called ‘work requirements’ are not about work at all … these requirements are not about jobs but are a cruel way for Republicans to take health care away from millions of people to give tax breaks to billionaires and corporations.”
Past experiments with work requirements in red states during Trump’s first administration serve as cautionary tales. In Arkansas, for example, work requirements were implemented with exemptions under a waiver. But the policy led to a significant reduction in Medicaid enrollment and an increase in uninsurance among low – income adults. In just the first seven months, 18,000 people, one – fourth of those subject to the requirement, lost their coverage. Exemptions, which were meant to protect people, proved to be ineffective in practice. And research showed no increase in employment as a result of the policy.
House Republicans also attempted to include work requirements for Medicaid recipients aged 19 to 55 in their 2023 Limit, Save, Grow Act. Although the legislation failed, the Congressional Budget Office estimated at the time that it would have resulted in around 1.5 million people losing their Medicaid benefits and hundreds of thousands being left uninsured.
Currently, Georgia is the only state with Medicaid work requirements. The program, known as Pathways to Coverage, requires low – income adults to report at least 80 hours of work or volunteer activities each month. But this has created significant strains. Only a small fraction of eligible people have enrolled, and the complex application process, made even more difficult by work reporting requirements, has deterred many from applying. Moreover, the cost of implementing the program has been far higher than initially estimated, with a large portion of the spending going towards administrative costs rather than actual healthcare.
House Speaker Mike Johnson (R – LA) claims that they are simply reducing fraud, waste, and abuse in Medicaid. But the evidence from Georgia and past experiences tells a different story. Medicaid work requirements are not the cost – saving measure Republicans pretend them to be. Instead, they are a costly and harmful policy that will leave millions without healthcare coverage, all while increasing administrative spending. As the political drama in Congress continues, it’s crucial for the public to see through the smoke and mirrors and understand the true impact of these proposed policies.
