Viewpoint: Federal Medicaid work requirements are unconstitutional

Forcing states to implement Medicaid work requirements would fail basic constitutionality tests, a group of health policy experts wrote in Health Affairs. 

In the article published May 3, professors at the Milken School of Public Health at George Washington University in Washington, D.C., argued federal work requirements for the program would "utterly depart from Medicaid's tradition of providing coverage to people at their most vulnerable." 

House Republicans have proposed Medicaid work requirements as part of their proposal to raise the debt ceiling into next year. The bill passed in the House April 26, though the bill is unlikely to pass the Democratic-controlled Senate. 

The proposal would result in 600,000 people losing Medicaid coverage, according to estimates from the Congressional Budget Office. 

In 2011, the Supreme Court ruled the federal government could not require states to expand Medicaid under the ACA. The same standard should apply to requiring states to add work requirements, the authors wrote in Health Affairs

"In short, Medicaid is all about getting health care to eligible people when they need it; this is its core purpose," the authors wrote. "By imposing a work requirement as a condition of state entitlement to payment, the bill would completely undo this foundational feature by withholding federal funding for reasons unrelated to basic eligibility factors and the need for care." 

Some states have moved to implement work requirements in their Medicaid programs. Arkansas Gov. Sarah Sanders is asking the federal government for a waiver to implement work requirements for Medicaid recipients. 

Arkansas implemented work requirements for Medicaid recipients in 2018. A federal judge blocked the requirements in 2019. 

Georgia is set to implement work requirements for Medicaid recipients in July.  

Read more here. 

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