Six in 10 able-bodied adults on the healthcare program have no earned income.
“New research and polling on Medicaid work requirements help to clarify the stakes [to address Medicaid’s rapid expansion]. More than six in 10 able-bodied adults on Medicaid report no earned income, according to a report from the Foundation for Government Accountability (FGA), a think tank. Voters tend to think of Medicaid as a safety net for low-income pregnant women and disabled Americans. But Barack Obama’s Affordable Care Act expanded the program into a permanent entitlement for childless men in prime working age.
Democrats claim those on Medicaid are working. You’ll hear statistics like this one from the Kaiser Family Foundation: 92% of able-bodied Medicaid adults under age 65 worked full or part-time, or were indisposed for a good reason such as caring for a relative or attending school.
But that figure is derived from government survey data, which are self-reported and rely on sample sizes as small as a few dozen. FGA, by contrast, obtained administrative records from state Medicaid agencies in 23 states, a far more complete picture of earnings for nearly 21 million able-bodied adults on Medicaid. It found that millions are declining to work at all, which is damaging to the country economically and culturally.
[..] the GOP’s proposed Medicaid work requirements in 2023 were extremely modest—20 hours a week, which could include training for a job or volunteering, say, at the local library.
Republicans offered exceptions for nearly anyone with a plausible reason. Pregnant, have children, or caring for an incapacitated relative? You’re exempt. Got a doctor’s note attesting that you’re unfit to work? Exempt. Ditto for anyone enrolled in school or getting help for alcohol or drug abuse. [..]
FGA’s more robust state data found 14,000 enrollees departed Arkansas’s program because their income increased—which should be good news. Medicaid is lousy insurance that doctors often don’t accept because of its low reimbursement rates. It should be a temporary last resort, and the GOP aim should be to move as many people as possible off the Medicaid rolls and onto employer options.
Some Republicans fear work requirements would alienate male MAGA voters, but that whiffs the politics. Some 62% of voters supported Medicaid work requirements in a recent Kaiser Family Foundation poll. That included 47% of Democrats, 60% of independents, and 82% of Republicans. [..]
Work as a condition for benefits is an American economic and cultural norm. If more healthy men get back into the workforce, and ultimately off Medicaid, the program will be able to focus on the poor for whom it was originally intended.
But “savings” aren’t the main reason to impose a work requirement. Too many Americans are checking out of work and civic life. Voters will reward a party with the conviction to do something about it—and the wit to fight back against Democratic distortions.”
Full editorial, WSJ editorial board, Wall Street Journal, 2025.4.14