Democrats Balk At GOP Effort To Rein In Medicaid With Work Requirements

Republicans are proposing Medicaid reforms to rein in government spending, but Democrats are presenting a unified front against plans that include tying Medicaid eligibility to work requirements.

In a session that stretched from Tuesday afternoon into the early hours of Wednesday morning, the House Energy and Commerce Committee — responsible for overseeing Medicaid — convened to deliberate on its portion of the budget reconciliation package to advance President Donald Trump’s agenda, according to Politico. House Republicans are seeking to attach work requirements to Medicaid as a means to decrease spending and support the administration’s priorities, but some Democrats are up in arms about conditioning Medicaid eligibility on work.

During the hours-long meeting, Texas Republican Rep. August Pfluger asserted that the work requirements would simply deny coverage to able-bodied adults who choose not to work, according to Politico. Pfluger reportedly asked Democrat Rep. Raul Ruiz of California whether there should be any work requirements for Medicaid eligibility, to which Ruiz reportedly responded, “No. That’s an easy one.”

“What I believe you’re doing, not intentionally, is figuring out every way possible for them not to qualify, either because they can’t fill out the paperwork [or] they don’t know how to do it,” said Democrat Rep. Frank Pallone of New Jersey, according to Politico.

However, Republican health subcommittee Chair Rep. Buddy Carter of Georgia stated that any reform to Medicaid will “not touch essential health care services for vulnerable populations,” the outlet reported.

The Congressional Budget Office (CBO) estimates the GOP-proposed federal work requirement — mandating most able-bodied adults without dependents to prove they work, go to school or volunteer — could yield $301 billion in savings over seven years. The proposed requirements, however, would not take effect until 2029 under the terms of the current version of the reconciliation bill.

The Obama administration expanded Medicaid eligibility dramatically through the Affordable Care Act to include nearly all adults with incomes up to 138% of the federal poverty level while increasing the federal matching amount available to states.

Other proposed Medicaid reforms include halting funding to abortion providers like Planned Parenthood and limiting states’ ability to impose additional taxes on healthcare providers, according to the text of the bill. Furthermore, Republicans are looking to reduce the federal share of Medicaid for states that provide taxpayer-funded health coverage to illegal immigrants.

CBO estimates suggest that about 7.6 million people would go uninsured if the GOP-proposed changes take effect, which the office says includes 1.4 million people without “verified citizenship, nationality, or satisfactory immigration status who would be covered in state-only funded programs under current law.”

“President Trump and Republicans are protecting Medicaid – and that starts with kicking 1.4 million illegal immigrants off the program to prioritize the Americans who need it,” said White House Spokesman Kush Desai in a statement shared with the Daily Caller News Foundation.

In 2023, Medicaid and Medicare lost more than $100 billion due to payment errors, including fraud, according to the Government Accountability Office.

The CBO estimates that the GOP’s various proposals could save up to $625 billion over a decade if they are all enacted as law.

While some spending hawks argue that the proposed savings don’t go far enough, other Republicans, like Missouri Sen. Josh Hawley, describe Medicaid reforms as “morally wrong” and “politically suicidal.”

“If Congress cuts funding for Medicaid benefits, Missouri workers and their children will lose their health care. And hospitals will close. It’s that simple,” Hawley argued in a May 12 New York Times op-ed.