Study: Only 8% of Medicaid Recipients are Able-bodied and Non-working

[Seymour Flops]

It is strange that these people are the hill Democrats are dying so horribly on:

https://www.ltsscenter.org/wp-content/uploads/2025/04/Medicaid-Population-Work-Requirements-Age-18-64-Analyses-4-20-2025.pdf

Here is another interesting set of stats from that study:

So if a third of that 8% is available for work or looking for work, then they self-identify as able to work.

The community service option would be perfect for them. One reason that they may not be finding a job if they are looking for one, is that they have a long gap in work history or no work history. Some time doing community service would brighten up their resume and give them references, assuming they work hard for the minimum 20 hours per week on average.

Why do I post these stats?

This is ripe for a compromise. Democrats drop their demand that illegal border crossers be given free health care if they were awarded "legal status" by the Autopen Administration and Repubs give able bodied Medicaid recipients an additional ninety days to find a job or find volunteer work.

If they are really about to lose Medicaid, that "able to work" subset will suddenly increase, believe me.

 

[Greenbeard]

Work requirements aren’t intended to get people to work or to remove benefits from the tiny fraction of non-working Medicaid beneficiaries. The point of creating a costly new Kafkaesque bureaucracy and endless new paperwork requirements is to ensure people who are eligible for benefits can’t access them.

 

[Seymour Flops]

Work requirements aren’t intended to get people to work or to remove benefits from the tiny fraction of non-working Medicaid beneficiaries. The point of creating a costly new Kafkaesque bureaucracy and endless new paperwork requirements is to ensure people who are eligible for benefits can’t access them.

Horseshit.

Democrats and "not Democrats" have never opposed Kafkaesque bureaucracy and endless paperwork requirements before and none of your politicians have cited this as a reason not to honor work requirements.

I give you a B for originality in excuse making, but an F for logic.

 

[Greenbeard]

As you've (correctly) noted, the actual population of able-bodied Medicaid enrollees who don't work is actually quite small. That should be your first clue something's up.

So what is it? The answer lies in the pilots that the GOP is now taking national.

And those illustrate very clearly that the point of Medicaid work requirements isn't to promote work, it's to create red tape that increases the probability of eligible people losing their coverage. See, for instance, the Arkansas experience:

As noted previously, over 95% of Arkansas beneficiaries in our survey already met the state’s Medicaid work requirements or should have been eligible for an exemption. This suggests that barriers to reporting data to the state – rather than not meeting the requirements themselves – was the main cause for coverage losses in 2018.

Similarly, Georgia's Medicaid work requirements have been a bureaucratic disaster to an almost mind-boggling degree, literally spending twice as much on implementing bureaucratic hurdles as it did on health care.

The First Year of Georgia’s Medicaid Work Requirement Is Mired in Red Tape - KFF Health News

Georgia must decide soon whether to try to extend a limited Medicaid expansion that requires participants to work. Enrollment fell far short of goals in the first year, and the state isn’t yet able to verify participants are working.

kffhealthnews.org

Georgia’s Medicaid Work Requirement Program Spent Twice as Much on Administrative Costs as on Health Care, GAO Says

Republican lawmakers cite Georgia’s Pathways to Coverage as a national model for federal Medicaid work requirements that are set to take effect in 2027. A new report shows the program has spent at least $54 million on administrative costs alone.

www.propublica.org

This isn't some well-kept secret, here's the Wall Street Journal reporting on this a few months ago:

Medicaid Work Requirements Have Mostly Failed. The GOP Is Still Pushing Them.

A short-lived program in Arkansas in 2018 didn’t boost employment among targeted residents, research has shown. The bureaucracy and confusion of the program also resulted in thousands of people losing their Medicaid coverage. . .Trevor Hawkins, an Arkansas lawyer who helped residents navigate the Medicaid program at the time, said the state website for submitting work reports wasn’t mobile-friendly and wouldn’t accept submissions after a certain time of night. People with more than one part-time job and fluctuating schedules—a common occurrence among Medicaid recipients—sometimes struggled to get enough hours or to gather paperwork from several employers to prove their hours, he said.

A current Medicaid pilot program in Georgia, meanwhile, has enrolled a fraction of the people the state aimed to register, in part because the monthly reporting requirements to prove employment are so cumbersome, according to doctors and healthcare experts. . .Uploading paperwork to the website often fails, according to Laura Colbert, executive director of the nonprofit Georgians for a Healthy Future. “You think you’ve uploaded it, but on the other end they can’t see it,” she said. Local benefits offices have limited hours and staff to help, she added.

Contra their headline, though, the pilots worked exactly as they were supposed to. Sure, if their aim had actually been to promote work and/or ensure only "deserving" beneficiaries got benefits, they failed spectacularly. But you wouldn't take pilots that failed spectacularly and decide to implement them on the national level. No, they did exactly what they were supposed to do: effectively used a bunch of useless red tape to deny benefits to people who are legally entitled to them.

This is not new, the GOP does this all the time. They famously rebuilt the unemployment system in Florida on this principle, which backfired in 2020 when COVID hit:

Gov. Says Florida's Unemployment System Was Designed To Create 'Pointless Roadblocks'

Amid staggering job losses in March and April, Florida's unemployment system was the slowest in the country to process claims. Residents described nightmarish experiences as they tried to get benefits. By April 20, just 6% of Floridians who had applied for unemployment benefits had received a check.

Gov. Ron DeSantis said that result was by design.

"Having studied how [the unemployment system] was internally constructed, I think the goal was for whoever designed, it was, 'Let's put as many kind of pointless roadblocks along the way, so people just say, oh, the hell with it, I'm not going to do that,' " DeSantis told a Miami CBS affiliate this week.

Florida's online system, known as CONNECT, debuted in October 2013 during the administration of DeSantis' fellow Republican Rick Scott, now a U.S. senator.

Now they're applying the principle to Medicaid. "Pointless roadblocks" to coverage for people entitled to it to prevent them from getting their coverage.

 

[Seymour Flops]

As you've (correctly) noted, the actual population of able-bodied Medicaid enrollees who don't work is actually quite small. That should be your first clue something's up.

So what is it? The answer lies in the pilots that the GOP is now taking national.

And those illustrate very clearly that the point of Medicaid work requirements isn't to promote work, it's to create red tape that increases the probability of eligible people losing their coverage. See, for instance, the Arkansas experience:


Similarly, Georgia's Medicaid work requirements have been a bureaucratic disaster to an almost mind-boggling degree, literally spending twice as much on implementing bureaucratic hurdles as it did on health care.

The First Year of Georgia’s Medicaid Work Requirement Is Mired in Red Tape - KFF Health News

Georgia must decide soon whether to try to extend a limited Medicaid expansion that requires participants to work. Enrollment fell far short of goals in the first year, and the state isn’t yet able to verify participants are working.

kffhealthnews.org

Georgia’s Medicaid Work Requirement Program Spent Twice as Much on Administrative Costs as on Health Care, GAO Says

Republican lawmakers cite Georgia’s Pathways to Coverage as a national model for federal Medicaid work requirements that are set to take effect in 2027. A new report shows the program has spent at least $54 million on administrative costs alone.

www.propublica.org

This isn't some well-kept secret, here's the Wall Street Journal reporting on this a few months ago:

Medicaid Work Requirements Have Mostly Failed. The GOP Is Still Pushing Them.



Contra their headline, though, the pilots worked exactly as they were supposed to. Sure, if their aim had actually been to promote work and/or ensure only "deserving" beneficiaries got benefits, they failed spectacularly. But you wouldn't take pilots that failed spectacularly and decide to implement them on the national level. No, they did exactly what they were supposed to do: effectively used a bunch of useless red tape to deny benefits to people who are legally entitled to them.

This is not new, the GOP does this all the time. They famously rebuilt the unemployment system in Florida on this principle, which backfired in 2020 when COVID hit:

Gov. Says Florida's Unemployment System Was Designed To Create 'Pointless Roadblocks'


Now they're applying the principle to Medicaid. "Pointless roadblocks" to coverage for people entitled to it to prevent them from getting their coverage.

Let's not pretend that Medicaid was not already plagued with bureaucracy and inefficiency long before anybody thought of work requirements.

Should we cancel Medicaid altogether? Because it is far more expensive than it would be if it were run by competent people instead of overpaid state and federal employees who prefer to "work at home" rather actually showing up.


Work requirements for Medicaid and other forms of welfare are extremely popular with taxpayers, a disproportionate number of whom are Republicans. Republican swept the most recent election and so republicans have their way for now.

You want to change that? Tell Democrats to dial down their ferver for their 80-20 issues like transgenderizing kids and men in girls' sports, and explain to us how they are going to keep their safety nets from becoming hammocks, for large numbers of people.

 

[Greenbeard]

Let's not pretend that Medicaid was not already plagued with bureaucracy and inefficiency long before anybody thought of work requirements.

CMS spent years streamlining Medicaid’s bureaucracy and eliminating red tape in accordance with the ACA’s requirements.

Medicaid Eligibility, Enrollment Simplification, and Coordination under the Affordable Care Act: A Summary of CMS's March 23, 2012 Final Rule | KFF

This brief provides a summary of the Centers for Medicare and Medicaid Services' (CMS) March 23, 2012 final rule to implement the ACA provisions relating to Medicaid eligibility, enrollment simplification and coordination. The rule, which is effective Jan.

www.kff.org

And the Biden administration picked up the baton.

Streamlining the Medicaid, Children’s Health Insurance Program, and Basic Health Program Application, Eligibility Determination, Enrollment, and Renewal Processes Final Rule Fact Sheet | CMS

The Centers for Medicare & Medicaid Services (CMS) is releasing the Streamlining Medicaid, Children’s Health Insurance Program, and Basic Health Program Application, Eligibility Determination, Enrollment, and Renewal Processes (CMS-2421-F2) final rule. This final rule will make it easier for...

www.cms.gov

Trump is, of course, reversing course yet again. One of the GOP’s core tenets is that the government should work as poorly, inefficiently, and frustratingly as possible.