Donald Trump · Democrats · Fortune Technology
Someone may be too frail to work but can’t afford to see a doctor to prove it
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Work requirements for some Medicaid beneficiaries begin across the U.S. in January, the result of President Donald Trump’s big 2025 tax cut and policy law, and a handful of Republican-led states are imposing tougher rules than the law requires.
Key facts
- The Medicaid changes are projected to save the federal government $887 billion over the next decade and result in 7.5 million fewer people with health insurance, according to the Congressional Budget
- In Arizona, for example, enrollment plummeted by 55% from April 2025 to April 2026, the biggest drop in the country, with more than 400,000 fewer people getting benefits now
- The new mandate applies to up to 20 million lower-income adults without children at home who are enrolled in Medicaid through an optional expansion in 40 states and the District of Columbia
- Work requirements for some Medicaid beneficiaries begin across the U.S. in January, the result of President Donald Trump’s big 2025 tax cut and policy law, and a handful of Republican-led states
Summary
At issue is how someone can prove they are too medically frail to work. Advocates say that could create problems, especially for new applicants to the joint state-federal health insurance program for lower-income people. “Someone may not be able to work, but they can’t see a doctor because they can’t afford it. As some Republican-led states take a tougher-than-required approach to implementing the federally mandated changes, Democrats in 25 states are suing and asserting that the rules are too harsh.