Work requirement waivers undermine pledge on Medicaid cuts

Despite Donald Trump's campaign promise, his administration has taken several steps to scale back Medicaid, the federal-state program that provides health insurance to low-income Americans.

The biggest move came in January 2018, when the Center for Medicare and Medicaid Services posted new guidance that allowed states to ask permission to require Medicaid recipients to meet a work requirement. While the program has been subject to litigation, a number of states have availed themselves of the opportunity.

According to the Kaiser Family Foundation, six states have received federal approval for work requirements, and 10 more were pending as of June 26, 2020. 

The work requirements "will have the effect of cutting federal Medicaid spending in those states, because fewer people will qualify if work requirements are imposed," Christine Eibner, a senior economist specializing in health care policy at the RAND Corp., told us when the requirements were first proposed.

Separately, the administration continues to ask the Supreme Court to overturn the Affordable Care Act, which expanded Medicaid in the states that chose to participate. The administration has also encouraged states to make it harder for some participants to enroll or remain enrolled.

The Supreme Court hasn't yet ruled in the ACA case, but the administration has done enough to counteract this pledge by allowing work requirements. We rate this a Promise Broken.