House Republicans passed a debt limit bill last month that included provisions expanding work requirements for cash welfare and food stamps while extending such requirements to Medicaid health coverage. While President Biden recently suggested an openness to some expansion of work requirements, negotiations on the scope of a potential debt limit package continue.
But conservatives need not confine themselves to whatever provisions Biden will accept. (He has suggested he would oppose work requirements in Medicaid). Even as federal lawmakers seek to expand work requirements in Congress, states have an obvious solution staring them in the face.
If state legislators seek to expand work requirements, they could accomplish their goal by exiting Obamacare’s expansion of Medicaid to the able-bodied. Doing so would promote work in ways that would save states money, without necessitating the administrative expense associated with enforcing an official work requirement.
A De Facto Work Requirement
The 2010 health care law included a categorical expansion of Medicaid eligibility to all those with incomes under 138 percent of the federal poverty level, or $41,400 for a family of four. While Obamacare initially required all states to expand Medicaid, the Supreme Court in 2012 made expansion a voluntary proposition.
Because most recipients of expansion were able-bodied adults — nearly 5 in 6 of whom lack dependents, according to a 2012 Urban Institute study — some conservative states declined to accept the expansion. But because Obamacare prohibits most individuals with incomes below the poverty level from receiving federal insurance subsidies, some people
