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medicaid work requirements

Congress Can Put Bureaucrats on the Sideline and Help Get Workers Back in the Game

The Foundation for Government Accountability’s new paper details how Congress can bypass D.C. bureaucrats and empower states to enact work requirements in their Medicaid programs

Naples, FL—Today, the Foundation for Government Accountability (FGA) released a new research paper illustrating the benefits of passing work requirements into federal law instead of relying on the Centers for Medicare & Medicaid Services (CMS) to grant waivers subject to political influence and upheaval every four or eight years.  

“President Trump helped unleash the American economy by reducing regulations and prioritizing work requirements throughout many taxpayer-funded welfare programs. President Biden has taken great pains to undo much of that effort. The resulting worker shortage, supply chain crisis, and rampant inflation speak for themselves,” said Michael Greibrok, FGA senior research fellow. “Congress can help states restore work requirements in Medicaid and make sure that bureaucrats don’t interfere with getting people back to work and getting the economy back on track.”

Before Medicaid expansion under ObamaCare, there were 60 million individuals enrolled in the program. Due to expansion and congressional handcuffs that kept ineligible individuals enrolled in Medicaid over the past three years, enrollment has reached an all-time high with an estimated 99 million individuals in the program.  

Forty percent of the current Medicaid population—an estimated 40 million people—are able-bodied adults.  Because the Biden administration rescinded or failed to grant states’ Section 1115 Waiver requests for work requirement, these individuals who could be working are sitting on the sidelines, missing out on the opportunity to learn new skills and participate in the economy. Work requirements for able-bodied adults would not only help boost workforce participation, but they would also reduce costs for states and the federal government—a win-win.

“Work should not be a political football tossed back and forth in the partisan winds. It’s the foundation of our American economy. Work requirements should be a priority in law instead of subject to waiver approvals black boxed in the bowels of the CMS bureaucracy,” said Michael Greibrok, senior research fellow. “Congress has the power to provided needed stability so states can budget resources for the truly needy and help guide those who can work back into the workforce. The solution to help state budgets and our ailing economy is simple—it will just take work.”

Additional Background:

The current labor force participation rate sits at 62.4 percent despite plentiful opportunities for work. There were a reported 11 million job openings across the country at the end of December 2022.


The Foundation for Government Accountability (FGA) is a non-profit, multi-state think tank that promotes public policy solutions to create opportunities for every American to experience the American Dream. To learn more, visit

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