Congress Passes Bill Linking Medicaid to Work Requirements \ Newslooks \ Washington DC \ Mary Sidiqi \ Evening Edition \ Congress approved legislation requiring work for Medicaid and expanding SNAP mandates. Advocates say it promotes self-reliance; critics warn of harm and administrative burdens. The law could impact millions, strain states, and defund providers like Planned Parenthood.
Quick Looks
- Work, education, or service now required for most adults on Medicaid or SNAP
- Millions may lose coverage, especially with tougher paperwork and recertification rules
- Exemptions exist for caregivers, health-impaired individuals—but difficult to verify
- State systems face overhaul and cost hikes to meet 2027 rollout deadlines
- Rural hospitals risk closures, Planned Parenthood faces defunding across U.S.
Deep Look
A sweeping federal tax and spending package recently passed by Congress and sent to President Donald Trump is set to usher in significant changes to safety net programs like Medicaid and the Supplemental Nutrition Assistance Program (SNAP). The bill introduces work requirements and administrative overhauls that supporters say will foster accountability, but critics warn it could destabilize lives, especially for vulnerable populations.
Under the new law, many Medicaid recipients aged 19 to 64 will be required to work, attend school, or perform 80 hours of community service monthly to maintain their benefits. This policy will impact people in 40 states that expanded Medicaid access under the Affordable Care Act. States like Texas and Florida, which opted out of expansion, won’t be directly affected—yet.
SNAP work mandates are also tightening. Previously, adults aged 18 to 55 had to meet work criteria; the age cap will now rise to 65. Though exceptions exist for caregivers of children under 14 and others with significant health conditions, meeting and verifying these exemptions poses a logistical hurdle.
For individuals like Theresa Gibbs, a mother of three who lost her job as a school bus driver, the changes are less concerning. She already qualifies for an exemption but supports the concept of work-linked benefits. Others, like Amanda Hinton, who battles fibromyalgia, fear for their health and stability if health conditions prevent them from meeting requirements.
Even those likely to meet the mandates remain anxious. Brittany Phillips of North Carolina, who works a temporary job while relying on Medicaid, says the program is vital for survival. “Medicaid should be accessible to everyone regardless of their circumstances,” she asserts.
Beyond the work rules, experts say administrative burdens may prove even more damaging. The Congressional Budget Office estimates that by 2034, nearly 12 million people could lose insurance, not only because of work requirements but due to stricter re-verification procedures. Medicaid enrollees must now confirm eligibility every six months—a process that could disqualify many through paperwork errors or missed deadlines.
Deborah Steinberg of the Legal Action Center warns, “Every form, every deadline—these are traps that people fall into.” Real-life cases support her claim: Julia Bennker, a home daycare provider in Wisconsin, temporarily lost coverage this year due to paperwork disputes despite meeting the rules.
Mental health and substance use disorders—both valid exemption grounds—are often unregistered in Medicaid systems, complicating efforts to protect those most at risk. “It’s not automatic,” notes Hannah Wesolowski of the National Alliance on Mental Illness. “People fall through the cracks.”
The law also shifts significant responsibility to states. By 2027, all states must implement the new Medicaid rules, overhaul their IT systems, and handle a larger share of SNAP administrative costs. By 2028, some may even be required to fund part of the food aid itself. Advocates like Sophia Tripoli of Families USA warn of a “tight and costly timeline” that many states are unprepared for.
Julieanne Taylor, a legal aid attorney in North Carolina, says the current system already strains her clients. “Adding more layers of red tape will push people off the programs, even those who qualify.”
Meanwhile, rural hospitals face an additional threat. The bill caps the hospital taxes that many states use to draw federal Medicaid funds—changes that the Kaiser Family Foundation estimates will slash rural Medicaid spending by $155 billion over 10 years. Health leaders like R. Kyle Kramer of Day Kimball Hospital fear a wave of closures unless relief is provided. The bill does allocate $50 billion in mitigation funding, but critics doubt it will suffice.
Another seismic shift: Planned Parenthood and similar organizations would lose all federal funding, not just for abortion services (already restricted), but also for cancer screenings, STI testing, and family planning. The organization warns that one-third of its 600 clinics may close, especially in states where abortion remains legal. Smaller providers like Maine Family Planning, with 19 sites and subcontracts with Planned Parenthood, could also lose essential funding.
As debate over the law intensifies, the country braces for the impact—on hospitals, households, and the future of federal aid.
Congress Passes Bill Congress Passes Bill
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