A new proposal from Republicans aims to change Medicaid, potentially impacting millions of adults who rely on the program for health insurance.
The Path to Independence Act, backed by nine sponsors, would allow states to impose work requirements on able-bodied individuals in the Medicaid program, a significant shift since current laws do not mandate employment for these recipients.
Previously, 13 states attempted to implement these work requirements, but their efforts faced opposition from the Biden administration. States like South Dakota, Missouri, and Idaho had substantial proposals blocked. While former President Trump permitted states to enforce work requirements, those waivers were revoked under Biden.
In response, Republican Representative Matt Rosendale from Montana stated, “The federal government should never dictate how sovereign states spend their money.” He emphasized that the new act would help ensure states’ finances remain stable and promote individual financial independence.
Proponents believe that implementing work requirements will better allocate resources to those truly in need and decrease dependency on government support. Mimi Singleton, a director at the Foundation for Government Accountability, noted the bill would help transform lives by leveraging the benefits of work.
Initially established in the 1960s for vulnerable populations, Medicaid now serves a significantly larger group. In 2000, there were 34 million participants, but that number soared to 96 million by 2023, coinciding with a drop in labor participation from 67.1% to 62.6% over the same period, according to Rosendale.
The COVID-19 pandemic further increased Medicaid enrollment due to emergency measures that expanded federal funding while preventing states from restricting eligibility or terminating coverage.
In Montana, Medicaid currently accounts for 25% of the state’s budget. However, Democrats generally oppose new work requirements, arguing that they could create complexities and harm vulnerable populations. Data shows that roughly 61% of non-elderly Medicaid recipients are already employed, while many of those not working are tied up with caregiving, health issues, or education.
Mia Ives-Rublee from the Center for American Progress pointed out that the work requirement would only target a small percentage of the Medicaid population. Some Republicans are also hesitant about the idea, suggesting that not everyone agrees on its necessity.