New Push for Medicaid Work Requirements Meets Wall of Opposition

Republicans in the U.S. House of Representatives have passed legislation that would require about one-third of Medicaid enrollees to be employed or looking for work, which would be a radical shift in the safety net program’s mission and operations. Although the bill has little chance of becoming law, given Democrats’ control of both the Senate and White House, many health care policy experts have been quick to name work requirements’ many downsides — and one health insurance trade group denounced the proposal.

The work requirements proposal narrowly passed the House on April 26 in a party-line vote. It’s part of H.R. 2811, the Limit, Save, Grow Act of 2023, a bill that is Republicans’ latest offer in ongoing negotiations with congressional Democrats and the Biden administration over raising the federal debt limit, which is projected to reach the current limit in July. The work requirements proposal is one part of a broader package of austerity measures. In a notable break with past work requirements policies, including those of the Trump administration, the H.R. 2811 proposal would make work requirements a part of the Medicaid program in every state. The Trump administration’s Medicaid work requirements policy required states to implement such programs through Section 1115 waivers, which allow states to waive certain Medicaid rules in order to test “budget-neutral” policy approaches aimed at better serving Medicaid populations.

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Peter Johnson

Peter Johnson

Peter has worked as a journalist since 2011 and has covered health care since 2020. At AIS Health, Peter covers trends in finance, business and policy that affect the health insurance and pharma sectors. For Health Plan Weekly, he covers all aspects of the U.S. health insurance sector, including employer-sponsored insurance, Medicaid managed care, Medicare Advantage and the Affordable Care Act individual marketplaces. In Radar on Drug Benefits, Peter covers the operations of (and conflicts between) pharmacy benefit managers and pharmaceutical manufacturers, with a particular focus on pricing dynamics and market access. Before joining AIS Health, Peter covered transportation, public safety and local government for various outlets in Seattle, his hometown and current place of residence. He graduated with a B.A. from Colby College.

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