After a federal judge blocked Kentucky’s Medicaid work requirement, President Donald Trump’s Council of Economic Advisers released a study that concluded many people who receive Medicaid benefits can work but choose not to.

The study explained, “The American work ethic, the motivation that drives Americans to work longer hours each week and more weeks each year than any of our economic peers, is a longstanding contributor to America’s success.”

The council’s study revealed that 60 percent of working-age Medicaid recipients who aren’t disabled worked fewer than 20 hours per week. Other studies, such as one from the Foundation for Government Accountability, found nearly 7 million Medicaid expansion enrollees are not employed.

The study justifies the Trump administration’s push to institute welfare reform policies. In April, Trump signed an executive order that instructs federal agencies to reform out-of-control welfare programs, including the institution of work requirements for able-bodied adults.

Expanding Medicaid to include able-bodied adults without dependents was a central strategy of the Affordable Care Act. President Barack Obama and other Democrats reasoned that if Medicaid — which was originally only intended to help the elderly, disabled and indigent by providing subsidized health insurance — were made available to able-bodied Americans, it is likely many would enroll in the program, which is exactly what happened. Tens of millions of Medicaid enrollees were added during Obama’s tenure, pushing the country closer to having a single-payer health care system.

Other than trying to keep people hooked on Medicaid, there is no reason to oppose work requirements for healthy Medicaid recipients, especially since numerous studies show Medicaid offers inferior health coverage for enrollees compared to private health insurance. This shouldn’t be surprising, either. Due to Medicaid’s low reimbursement rate, fewer health care providers accept Medicaid patients.

Under the leadership of Seema Verma, the Centers for Medicare and Medicaid Services has dedicated itself to granting to the states the flexibility they need to reform their Medicaid programs. To date, CMS has approved waivers for state-based reforms such as work requirements for 19 states.

The Council of Economic Advisers study suggested it might be necessary to pass federal legislation that mandates states impose work requirements to help ensure state lawmakers are doing everything they can to help Americans move from government dependency to self-sufficiency. “Low employment rates of non-disabled working-age recipients suggest that legislative changes requiring them to work and supporting their transition into the labor market would affect a large share of adult beneficiaries,” the report’s authors concluded.

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Because Congress has repeatedly failed to repeal and replace Obamacare, the Trump administration has taken matters into its own hands. States should take advantage of this opportunity to reform their skyrocketing Medicaid programs by embracing free-market reforms, including the expansion of health savings accounts and direct primary care programs. To do otherwise would be to continue to entice more people to join the inferior Medicaid system, trapping many families in poverty.


Editor’s note: Lee is a research fellow at The Heartland Institute. She wrote this for

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POINT OF VIEW: Medicaid recipients who can work, should work