House Committee's Medicaid Work Requirement Bill Could Cut Coverage for Millions

Georgia currently operates the only Medicaid work requirement program in the U.S., and draft legislation pending in the House Energy & Commerce Committee could extend such requirements to tens of millions of low-income Americans nationwide.

The proposed bill aims to reduce federal spending on health care subsidies by imposing work requirements for individuals enrolled in Affordable Care Act (ACA) marketplace plans who earn under $23,400 annually. This measure is part of broader efforts to cut federal health care funding by hundreds of billions of dollars while preserving permanent tax cuts for higher income groups. Proponents argue that work requirements promote fiscal responsibility and reduce government waste, while critics point to data showing that over 60% of Medicaid recipients are already employed.

Health care advocates highlight challenges with bureaucratic compliance, noting that onerous verification processes often lead to coverage loss even among those who meet work criteria. The Congressional Budget Office estimates that about 13.7 million people could lose health insurance by 2034 due to this legislation, which also proposes cuts to ACA subsidies.

Representative Buddy Carter, a Republican from Georgia and a member of the House Energy & Commerce Committee, supports these reforms, emphasizing sustainability over outright cuts to Medicare and Medicaid funding. Georgia's Medicaid work requirement pilot, Georgia Pathways to Coverage, has faced difficulties with monthly eligibility verification and enrolling a small fraction of eligible participants despite costing taxpayers over $51 million. The state has requested federal approval to switch to annual verifications to reduce administrative burdens.

Despite these challenges, the draft bill mandates monthly verification across all states, leaving implementation details to state governments. This legislation reflects ongoing debates over Medicaid policy, federal budget priorities, and the balance between program sustainability and access to health coverage.