Legal attempts to muddy the waters of state-led welfare reforms won’t work. Despite the recent federal court ruling pausing Medicaid work requirements in Kentucky and Arkansas, states are (and should be) pressing forward to empower more Americans through the power of work.
Since 2000, the number of able-bodied adults on Medicaid has quadrupled. Most of these welfare recipients are not working, and the cost to states has been on the rise. Today, nearly one-third of every dollar in state budgets is devoted to Medicaid spending. Lawmakers need a solution to realign the program to its original intent to serve the truly needy. Work requirements are the antidote.
Since the Trump administration gave states the green light to apply for waivers to implement work requirements for able-bodied adults on Medicaid, more than a dozen states have moved forward. Medicaid work requirements are widely supported, and notably, more than a year after Kentucky’s application was approved, 74% of Kentucky voters are still anxious to see them implemented in the Bluegrass State despite legal action to stop them.
There’s good reason for that support: Requiring able-bodied adults on food stamps to work, train, or volunteer at least part-time is incredibly effective at moving individuals out of dependency. After work requirements were implemented in other programs, able-bodied adults leaving welfare found jobs in more than 1,000 different industries, touching virtually every corner of the economy. Their incomes more than tripled on average, more than offsetting lost benefits.
It’s common sense that policymakers should want to extend the benefits of work requirements to the Medicaid population. Work requirements effectively help low-income individuals and families attain their ability to be independent — a core objective of the Medicaid program. Despite the recent ruling pausing the waivers in Kentucky and Arkansas, work requirements are exactly what the Medicaid program needs.
It’s important to note that the ruling did not suggest work requirements were illegal, but instead paused the states’ waivers based on purely procedural grounds. The court argued that the waivers’ impact on Medicaid eligibility wasn’t adequately analyzed, including provisions unrelated to work requirements.
This decision was not a reversal of the guidance provided by the Trump administration last year, and the Trump administration has rightly appealed the court’s ruling. States are still fully able to apply for and implement work requirements, and with the support of the administration and the public, that’s exactly what they should do. To do otherwise would be to allow the program to continue to be overrun with more adults capable of working, threatening state resources for education, public safety, and the truly needy.
Centers for Medicaid and Medicare Services Administrator Seema Verma has indicated that administration will “continue to defend” and “vigorously support” these waivers. Medicaid work requirements are still supported by the majority of voters across the country. State leaders should continue to push forward to give their constituents the reforms they want and desperately need.
Jonathan Ingram is the vice president of policy and research at the Foundation for Government Accountability.
