Crystal Strickland had to wait years to qualify for Medicaid, which she needed due to a heart condition. Strickland, who is unable to work because of her condition, was outraged to learn that the United States House of Representatives had passed a bill that would require many nondisabled people to work to obtain health insurance through the program which is designed for low-income, disabled, and elderly Americans.
“What sense does that make?” she asked. “What about the people who can’t work but can’t afford a doctor?” The provision is part of President Donald Trump’s “Big Beautiful” bill which passed the House last month and is now being debated in the Senate. President Trump wants it passed by July 4.
Proponents say the idea behind the job requirement is simple. They want to reduce fraud and also ensure that nondisabled people who can work are not on Medicaid.
There are exceptions for those under the age of 19 or over the age of 64, people with disabilities, pregnant women, primary caregivers for young children, people recently released from prisons or jails, and during certain crises.
Work requirements could have a devastating impact. According to the Center on Budget and Policy Priorities, work requirements for Medicaid recipients could put 36 million Americans, or 44% of all Medicaid enrollees, at risk of losing their health insurance.
Historical data has shown that work requirements are not successful. According to the state Department of Human Services, in Arkansas, there were 265,223 Arkansas Works enrollees, with more than 62,000 of them affected by new work requirements. More than 18,000 people had lost Medicaid coverage by December 2018, because they did not meet the qualifying requirements.
In addition, a study of the Arkansas plan found that a third of the people subject to the policy had not heard about it. 44% of the target population was unsure whether the requirements applied to them.
Medicaid provides essential services to millions of people in this country. Previous work requirements have proven unsuccessful. Regardless of employment status, everyone should have access to affordable healthcare.
Sources:
Froelich, Jacqueline. “In Arkansas, Thousands of People Have Lost Medicaid Coverage over New Work Rule.” NPR, NPR, 18 Feb. 2019, https://www.npr.org/sections/health-shots/2019/02/18/694504586/in-arkansas-thousands-of-people-have-lost-medicaid-coverage-over-new-work-rule.
Mulvihill, Geoff. “Medicaid Enrollees Fear Losing Health Coverage IF Congress Enacts Work Requirements.” AP News, AP News, 15 June 2025, apnews.com/article/medicaid-work-requirement-worries-disability-health-trump-58feb16ce507c8ed467a71c0be27c38a.
Lukens , Gideon, and Elizabeth Zhang. “Medicaid Work Requirements Could Put 36 Million People …” The Center on Budget and Policy Priorities, The Center on Budget and Policy Priorities, 5 Feb. 2025, http://www.cbpp.org/research/health/medicaid-work-requirements-could-put-36-million-people-at-risk-of-losing-health.
Sommers, Benjamin D., et al. ‘Medicaid Work Requirements In Arkansas: Two-Year Impacts On Coverage, Employment, And Affordability Of Care’. Health Affairs, vol. 39, no. 9, Health Affairs, Sept. 2020, pp. 1522–1530, https://doi.org/10.1377/hlthaff.2020.00538.
Why want work requirements that don’t work? There is usually a reason behind the reason. Who knows what sick reason lurks underneath.