REFORM (fed)- GOP eyes new work requirements for millions on Medicaid, food stamps


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The demand from House Speaker Kevin McCarthy comes as the White House rejects talks on policies that could cut benefits to low-income Americans

House Speaker Kevin McCarthy (R-Calif.) at a bill-signing ceremony in March. GOP leaders are looking at proposals to require recipients of some federal aid to work. (Jabin Botsford/The Washington Post)


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House Republicans are eyeing new work requirements for millions of low-income Americans who receive health insurance, money to buy food and other financial aid from the federal government, reprising the party’s historic crusade against welfare as some lawmakers seek new ways to slash spending.

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In recent weeks, the GOP has focused its attention on two anti-poverty programs: Medicaid, which enrolls the poorest families in health insurance, and food stamps, which provide grocery benefits to those in need. Top lawmakers including House Speaker Kevin McCarthy (R-Calif.) have publicly endorsed rules that could force some enrollees to find a job and work longer hours — or risk losing the government’s help entirely.

The demands largely come in the context of a brewing fight over the federal budget. Many Republicans have said that federal aid programs offer a way for policymakers to boost U.S. workforce participation while saving Washington money — a stance that infuriates Democrats, aid workers and others, who say such changes could harm vulnerable families still reeling since the coronavirus pandemic.

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The debate in some ways resembles the Republican-led campaign against so-called welfare queens in the 1990s, when a politically resurgent GOP — then under the leadership of House Speaker Newt Gingrich — secured a dramatic restructuring of the government’s social safety net. The resulting overhaul, enacted by President Bill Clinton, slashed cash benefits for millions of Americans in ways that GOP leaders now cite as a model.

“I don’t think hard-working Americans should be paying for all the social services for people who could make a broader contribution and instead are couch potatoes,” Rep. Matt Gaetz (R-Fla.), a member of the far-right House Freedom Caucus, said at a news conference last month.

At the center of the standoff is the debt ceiling, the statutory limit on how much the U.S. government can borrow to pay its bills. Lawmakers must raise that cap as soon as June or risk a federal default — an economic calamity that GOP leaders have tried to exploit in hopes of advancing their agenda.

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In a letter published late last month, McCarthy called on President Biden to negotiate and spelled out his party’s latest demands. That included steep spending cuts and new policies “strengthening work requirements for those without dependents” — a reference to children — citing the fact that Biden supported the welfare-to-work approach adopted under Clinton in the ’90s.

Biden has refused to haggle over the debt ceiling and instead demands that Republicans raise it and preserve the country’s credit without conditions. The president has expressed a willingness to discuss broader fiscal issues with McCarthy, but White House aides have outright rejected any changes to food stamps and Medicaid that reduce enrollment.

“The President has been clear that he will oppose policies that push Americans into poverty or cause them to lose health care,” White House spokesman Michael Kikukawa said in a statement. “That’s why he opposes Republican proposals that would take food assistance and Medicaid away from millions of people by adding burdensome, bureaucratic requirements.”

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Still, top Republicans have unveiled a battery of proposals, including one targeting Medicaid, hoping to deliver on a long-sought conservative goal to add work requirements to the insurance program.

In February, Gaetz released legislation that would deny benefits to able-bodied adults unless they work for 120 hours per month, volunteer or participate in a work program for 80 hours, or participate in a combination of those activities. The congressman did not respond to a request for comment.

It is unclear whether other Republicans would support that approach. Gaetz’s bill does not yet appear to have any co-sponsors, but the hard-right bloc to which he belongs, the House Freedom Caucus, generally endorsed work requirements in its own demand letter last month. The group didn’t specify any programs, but Rep. Scott Perry (R-Pa.), the caucus’s chairman, later told The Washington Post that he wants nationwide work requirements for Medicaid.

The new conservative push is especially potent because Republicans’ razor-thin House majority gives its hard-right faction powerful leverage. It also arrives at a tumultuous time for Medicaid, which saw enrollment balloon by about 30 percent at the height of the pandemic.

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During the crisis, lawmakers enacted temporary rules that essentially prevented states from culling their Medicaid rolls. But those prohibitions expired on April 1, opening the door for state health officials to begin reevaluating eligibility. Approximately 15 million low-income Americans are ultimately expected to lose their coverage as a result, including 6.8 million who still qualify for the program, according to federal estimates in August.

At the White House, Biden has leaned into health care as a campaign message ahead of a potential 2024 reelection bid. In an interview last month, his Medicaid chief criticized work requirements.

“On work requirements, I think the administration’s position is really clear about being very much concerned about putting up barriers to people getting coverage,” said Chiquita Brooks-LaSure, the administrator of the Centers for Medicare and Medicaid Services. “It’s critical that we have coverage in this country … and there are other ways to really address making sure that people are able to find employment.”

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The two parties have previously battled over work requirements in the safety net program. In 2018, the Trump administration issued optional guidance for states to implement work rules in Medicaid for the first time, contending it would incentivize healthy people to find employment. Democrats seized on the issue, arguing the policy would hurt vulnerable Americans and was designed to curtail Medicaid enrollment.

Thirteen states adopted such rules under President Donald Trump. Once Biden took office, however, his Medicaid agency quietly began to send letters rescinding states’ Medicaid work requirements, which already faced a flurry of legal challenges and weren’t in effect. Only one state, Arkansas, imposed a work requirement for a significant period. Over more than nine months, about 18,000 adults lost coverage for failing to comply with the rules, and only about 1,900 re-enrolled in the program before a federal judge blocked the work rules.

Since then, the state’s new governor, Sarah Huckabee Sanders (R), has said she will try again under different rules — while a work requirement in Georgia is slated to begin this summer. Nationally, Republicans have argued that such mandates could increase labor force participation, even as the unemployment rate remains low.

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“This is the perfect time to have work requirements because people are needed, they’re wanted,” said Rep. Brett Guthrie (R-Ky.), chairman of the House Energy and Commerce health subcommittee. “Wages are rising because there’s a shortage of workers, so it’s a good opportunity for people to better themselves moving forward.”

For some Republicans, though, the push doubles as an opportunity to reduce the federal debt, which exceeds $31 trillion. At a House hearing in early April, Rep. Darin LaHood (R-Ill.), the new chairman of the House Ways and Means subcommittee on work and welfare, stressed that lawmakers had to ensure more “accountability for federal taxpayer dollars.”

In doing so, Republicans have signaled their focus could be broad in scope, potentially including the benefits the government provides for housing, child care and other key services.

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“We should be exploring every possibility to get our fellow Americans back into the labor force, including strengthening work requirements across all government programs,” added Rep. Jason T. Smith (R-Mo.), the leader of the House Ways and Means Committee.

Tasked to prepare a spending blueprint for the 2024 fiscal year, the House Budget Committee last week specifically called attention to what it described as a “culture of government dependency,” citing an uptick in spending in Medicaid and other federal programs, including food stamps, unemployment insurance, disability benefits and tax credits for low-income parents with children.

The panel’s chairman, Rep. Jodey Arrington (R-Tex.), said in a previous interview that Republicans are “going to look at health care” with the goal of reducing costs, stressing that decisions “haven’t been made” about what to propose on Medicaid. Broadly, though, Arrington long has endorsed work requirements on aid programs, especially in the case of food stamps.

Formally known in Washington as the Supplemental Nutrition Assistance Program, or SNAP, food stamps provide lower-income households with an average of more than $230 each month for groceries, often paid through a debit card. Approximately 41 million people are currently enrolled in the program, according to the government.

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Under existing law, SNAP already requires many adults without children to seek employment and training. But GOP leaders argue that the rules are too lax, exempt too many beneficiaries from work and open the door for states to make too many exceptions.

One key bill from Rep. Dusty Johnson (R-S.D.), a top ally of McCarthy, would rewrite some of the program’s rules, chiefly by subjecting Americans without children between the ages of 49 and 65 to SNAP work requirements. (Current rules for these adults only apply up to 49.) The proposal, which has more than three dozen GOP co-sponsors, also would limit states’ ability to waive some of those rules.

“This is not about balancing the budget on the backs of anyone,” Johnson said in an interview, adding that there is “no reliable pathway out of poverty” that doesn’t involve work, education and training.

But the changes could force more than 10 million people off food stamps, according to the left-leaning Center on Budget and Policy Priorities, which estimates the cut would affect 1 in 4 SNAP recipients. Even those who retained monthly food aid could face additional hardship, because they could be forced to work longer hours in ways that affect their ability to care for their children, CBPP found.

Johnson disputed that analysis. Still, it could be the second blow to SNAP recipients in recent months, after Congress allowed a pandemic benefit program to expire in March, slashing millions of families food benefits by an average $82, according to the Food Research and Action Center. Some Republicans still have signaled discomfort over targeting SNAP in the ongoing budget debate.

Democrats, meanwhile, have pledged to oppose any such changes, setting up a clash that could come to head even if the GOP does not pursue changes in talks around the debt ceiling. Lawmakers also must act by Oct. 1 to approve legislation known as the Farm Bill, which authorizes a bevy of federal farm and nutrition-related programs.