Medicaid work requirements misunderstood: Let's save welfare dollars for those truly in need

Work requirements are a proven, popular solution to our nation’s dependency crisis, but once again, a progressive judge has taken it upon himself to legislate from the bench and stop efforts to expand the power of work to millions of Americans.

Last week, a federal judge in Washington, D.C., halted the Arkansas and Kentucky Medicaid work requirement programs, calling them "arbitrary and capricious because [they] did not address ... how the project would implicate the 'core' objective of Medicaid.”

But that couldn’t be further from the truth. A core objective of the Medicaid program is to help individuals attain capability for independence—which is exactly what work requirements achieve.

According to our research, there are 28 million able-bodied adults in the U.S. who are dependent on Medicaid—and the majority of this group is not working at all. These numbers have increased, even as the economy has improved.

In fact, the number of able-bodied adults on Medicaid has quadrupled since 2000. Medicaid spending has tripled in the same time frame, with one out of every three state dollars now being spent on the program.

The program that was designed to serve the neediest among us—the disabled, pregnant women, poor children and the elderly—has now been overrun with adults who are capable of working. Every dollar that’s spent on this group is a dollar that can’t be spent on those who are in true need.

States are looking for a better path forward, and proven reforms like work requirements offer an opportunity to reroute the program. According to our research, after work requirements were implemented in welfare programs, individuals more than tripled their incomes within just a few years and found work in over 1,000 different industries. Those leaving welfare were empowered to secure a better, independent future for themselves and their families. To date, 15 states—and counting—are pursuing Medicaid work requirements.

It’s no wonder states are seeking to adopt welfare reforms that promote work and opportunity. Beyond the benefits for both those leaving welfare and states’ budgets, this reform is popular: polling shows that the majority of voters—including those in Arkansas and Kentucky—support Medicaid work requirements. The public sees a broken system, and they want it righted.


The ruling is an attempt to kill the growing momentum behind commonsense welfare reform, but it should only serve to fire up those who want to help empower people through work. They have the public’s support and the facts on their side: work requirements work.

Reform-minded governors and the Trump administration know this, which is why there continues to be momentum to enact smart rules and legislation that moves people off the sidelines and back to work. With seven million open jobs, now is the time for action.

Kristina Rasmussen is the vice president of federal affairs at the Foundation for Government Accountability.