CounterPunch Exclusives

CounterPunch Exclusives

Shoddy White House Research Claims Work Requirements Will Increase Employment and Reduce Poverty

Ford House Office Building, headquarters for the CBO. Photograph Source: APK – CC BY 4.0

As I noted in an article earlier this month, the Congressional Budget Office (CBO) estimates that the federal government will save $911 billion over 10 years and that 10 million people will lose health insurance as a result of Medicaid changes in H.R.1, aka the One Big Beautiful Bill Act (OBBBA). This bill requires near-poor, able-bodied Medicaid beneficiaries with incomes currently above the poverty line but under thresholds that depend on family size — $22,025 for an individual or $45,360 for a family of four — to navigate a maze of red tape and reporting requirements twice a year to remain enrolled. Disabled people on Medicaid, including those with cancer or end stage renal disease, will have to prove that they are too disabled to work in order to waive the work requirement.

An analysis by health policy organization KFF found that in 2023, 64 percent of adults 19 to 64 years of age enrolled in Medicaid were working either full or part-time. Nearly 30 percent were not working because of caregiving responsibilities, disability or school attendance — barriers to employment that typically exempt people from work requirements in programs that mandate them. Most of the 8 percent who were not working were retired or unemployed. The result is that only a small share of Medicaid enrollees will lose access to the program because they do not meet work requirements. However, many more will lose coverage because of the difficulty of navigating the reporting requirements and the administrative red tape built into the OBBBA for this purpose.

In June 2026, HHS released interim regulations for the changes to Medicaid that states must implement by January 1, 2027. The regulations are much more severe than the requirements in H.R.1, and have upended work that states had already done to be ready to comply by the January 1 deadline. This has forced states to scramble to be ready in just six months, an extraordinarily short window to prepare for the large changes in reporting requirements. Disenrolling people by mistake may mean the difference........

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