While data show that the majority of Medicaid enrollees are working, there has been long-standing debate about imposing work requirements in Medicaid. For the first time in the history of the Medicaid program, the Trump Administration approved Section 1115 waivers that included work and reporting requirements as a condition of Medicaid eligibility in some states. However, courts struck down many of these requirements and the Biden Administration withdrew these provisions in all states that had approvals. Arkansas was the only state to implement Medicaid work requirements with consequences for noncompliance.
Work requirements are now back on the agenda as some Congressional Republicans have indicated that they will rely on a budget outline that would require Medicaid enrollees to work, or look for work, in order to receive coverage. In a speech on April 17, Speaker McCarthy emphasized work requirements as part of negotiations to increase the debt limit, and such requirements were included in the Republicans’ proposed debt limit bill released on April 19. In addition, Republican legislators in several states have proposed seeking work requirement waivers. In July 2023, Georgia intends to expand Medicaid eligibility to 100% of the federal poverty level (FPL), with initial and continued enrollment conditioned on meeting work requirements (after a federal judge overturned the Biden Administration’s withdrawal of Georgia’s work requirement).
Experience in Arkansas and earlier...
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