Republicans in Congress are planning to slash funding for Medicaid in order to help pay for major tax reductions for wealthy Americans and corporations. But they don't want to cut Medicaid openly, because it will gravely injure many people who voted for them.

One way to cut Medicaid expenditures without overtly reducing benefits is to increase required paperwork. Additional bureaucratic hassle will discourage people from applying for what they are eligible for. The "big beautiful bill" currently discussed in Congress incorporates this strategy.

The major provision aimed at saving money requires Medicaid recipients to work at least 80 hours a month.

Until American conservatives wise up and emulate the conservatives in Taiwan, who introduced universal medical insurance there, we will have to live with a lot of unnecessary complexity and inflated administrative expense.

The work requirement requires frequent verification that a recipient is employed—more hassle. It will deny coverage to individuals who—for one reason or another—can't find work.

Given likely job loss due to artificial intelligence, mass corporate layoffs, and huge reductions in government payrolls, the number of people without insurance because they can't find work will likely be large.

This policy will be rather hard on people who through no fault of their own are unable to find work. And inability to get medical treatment may leave some people in such poor health that it makes it even harder to find and hold a job.

The work requirement, though, appears to be popular when people are polled. But many of the polled people may underestimate the danger that they themselves will lose their jobs, their job-related insurance, and their eligibility for Medicaid.

Fortunately, the bad consequences of the requirement could be completely eliminated by one simple additional government policy: that it will hire anybody who is otherwise unable to find work.

There is, of course, no end to the useful work that people employed by the government could do: elderly people who need help in their daily lives, children who could use tutoring, parks that need to be cleaned up,........

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