Americans Like Medicaid—But They Also Like Work Requirements

We know this because several states have imposed work requirements on Medicaid. In Arkansas, 18,000 people were kicked off Medicaid because of the work requirements after six months, despite many of them still being eligible, and 17,000 were disenrolled in New Hampshire after two months, despite the state trying to prevent the problems Arkansas had. (Arkansas’s work requirements were shut down in 2019 by a federal judge—in fact, by District Court Judge James Boasberg, who has been a thorn in Trump’s side in his second term, too. New Hampshire suspended its program shortly after it went into effect.) States have had similar problems when instituting work requirements for other programs, like nutrition assistance.

Work requirements are based on the groundless notion that social programs are rife with abuse. Fraud in these programs is rare, usually committed by health care providers, and rooted out and prosecuted when it occurs. Overall, Americans are much more likely to forgo aid when they need it than commit fraud to try to receive it when they don’t. And supporters and administrators of programs like Medicaid often point to a simple fact that should be obvious: People can’t work, or look for work, if they have unaddressed health problems. They can’t afford enough food. And they don’t have anyone to take care of their children while they’re away from home. Unemployed workers can apply online for jobs or pound the pavement with their resumes in hand, but they can’t force employers to hire them or find jobs that don’t exist. These are the arguments in favor of a social safety net in the first place, and tying them to work would undermine their purpose of being there when people need them most.

The KFF poll did find that support for work requirements dropped when those surveyed heard that most Medicaid recipients already work. But all of these counterarguments took paragraphs to make. Mention things like program design, work requirements, and recertification, and people’s eyes start to glaze over. It is overall a less appealing message than the simple idea presented by Republicans, which is that people should have to work if they’re going to receive government assistance. That’s the challenge Democrats have already faced in attacking the bill, as they highlight the paperwork requirements and funding mechanisms that would result in slashing benefits—while Republicans sneakily claim that they’re not cutting benefits directly.