Key Trump candidate hints at work requirements in Medicaid

Russell T. Vought, President Trump’s nominee to head the Office of Management and Budget, told Senate lawmakers during a confirmation hearing Wednesday that he supports work requirements for low-income Americans receiving state-subsidized health insurance, a policy Mr. Trump continued in his first term but which the Biden administration has largely reversed.

The comments suggest the Trump administration would likely seek sweeping reforms of how the federal government administers Medicaid, the joint federal-state health insurance program for more than 70 million people. They also signaled that labor requirements were likely to become a focal point of Mr. Trump’s approach to the American safety net.

Mr. Vought cited as a model the welfare reform bill signed into law in 1996, which required low-income Americans to prove they were working before receiving Social Security benefits.

“This allows not only Medicaid, but other programs, to be able to encourage people to re-enter the workforce, increase workforce participation and restore people’s dignity of work,” he told members of the Senate Budget Committee.

Democrats have sharply criticized adding work requirements to Medicaid, saying they require complex enrollment procedures that make it difficult to obtain and maintain coverage, thereby excluding people without other health insurance options. Most Medicaid recipients are already working, while many of those who aren’t are caring for their families or managing debilitating health conditions.

Congressional Budget Office estimates indicate that Medicaid work requirements would leave about 600,000 people uninsured but would reduce federal spending by at least $100 billion over a decade.