Why the ‘Big, Beautiful Bill’ Medicaid Work Mandates Won’t Get More People Working

Conservative lawmakers argue they are providing a “path to dignity” by including Medicaid work requirements in the tax and budget overhaul that was sent to the Senate on Thursday. While there are many ways to promote employment, the evidence shows that these requirements would not actually increase the number of Americans who are working, just the number of Americans who are uninsured.

Millions would suffer this fate not because they are no longer eligible, but because they would get caught up in red tape from the new eligibility reporting requirements, according to multiple published studies and analyses by outside experts. Instead of moving toward dignity or opportunity, unenrolled beneficiaries would be unable to afford basic health care, actually making it harder for them to succeed economically.

The proposed budget requires that most Medicaid recipients work, volunteer or study at least 80 hours a month to qualify for the health insurance; pregnant individuals, parents of dependent children and people who qualified for Medicaid due to a disability are supposed to be exempt. Largely because of the bill’s work reporting mandate, more than 7 million Americans are expected to lose Medicaid coverage, according to an analysis by the nonpartisan Congressional Budget Office. Outside experts have suggested even more people could be removed. According to these analyses, any savings would largely come from denying services to the target groups these programs are meant to serve.