Independent Journalism Center

When Congress passed, and President Donald Trump signed, the “One Big Beautiful Bill Act,” work requirements for able-bodied individuals on Medicaid were among the changes enacted.

Under the legislation, able-bodied adults who have no children and are between the ages of 19 and 64 are required to complete at least 80 hours per month of work, volunteering, education, or job training to maintain Medicaid eligibility.

Numerous groups are exempted from the work requirement, including parents, guardians, caretaker relatives of dependent children, disabled family members, individuals with disabilities, people with substance use disorders and serious medical conditions, veterans with disabilities, and former foster youth.

Even with all those exemptions, the work-requirement provision is expected to reduce Medicaid enrollment nationwide and restrain taxpayer costs significantly over the next decade as millions of current beneficiaries leave the program because they have achieved earnings sufficient to no longer need taxpayer support, or because they chose to leave the program rather than work.

Watching Television, Playing Video Games

Kevin Corinth, a senior fellow at the American Enterprise Institute, has estimated that between 40 percent and 56 percent of childless, non-disabled Medicaid recipients aged 19–64 would have failed to meet the work requirement if it had been in place in 2022.

Corinth’s research examined data from the American Time Use Survey (ATUS) as well as the Current Population Survey Annual Social and Economic Supplement (CPS ASEC), which asks about health insurance coverage two to five months before individuals received the time-use survey.

Corinth found that among Medicaid recipients who did not report working, individuals typically spent 4.2 hours per day watching television and playing video games, or 125 hours during a 30-day month. That is more than 50 percent higher than the 80 hours of required work or volunteer activity.

Overall, Corinth found those Medicaid beneficiaries spent on average 6.1 hours per day, or 184 hours per month, on all socializing, relaxing, and leisure activities (including television and video games). In contrast, those individuals spent just 22 minutes a day looking for work, four hours doing housework and errands, and 28 minutes caring for others.

‘Anyone Who Can Go to Work Must Do So’ In 2020, by an extremely narrow margin, Oklahoma voters opted to expand the state’s Medicaid program to provide medical welfare benefits to certain able-bodied adults.

An April report from the Oklahoma Health Care Authority, which administers the Medicaid program, shows that 229,154 able-bodied adults in Oklahoma are enrolled in Medicaid due to expansion. That group will be the most impacted by work requirements.

The work requirements imposed for Medicaid beneficiaries are similar to work requirements imposed on food-stamp and other welfare recipients in the 1990s during the presidential administration of Democrat Bill Clinton, who campaigned vowing to end welfare “as we know it.”