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FGA Applauds Trump Administration for Issuing Guidance on Medicaid Work Requirements

Washington, D.C. – The Foundation for Government Accountability applauds the Trump administration for announcing new flexibility for states to create Medicaid work requirements and move millions of Americans from welfare to work.

New guidance, released today by the Centers for Medicare and Medicaid Services, outlines key criteria for states who are interested in applying for Section 1115 waivers to implement work requirements for able-bodied adults on Medicaid. Under the guidance, states will have new flexibility to require able-bodied adults to work, train, or volunteer as a condition of Medicaid eligibility. This will finally bring Medicaid into alignment with other major welfare programs, which have successfully used similar rules for decades.

Today’s guidance is welcome news to governors and state legislators across the country, who are already grappling with skyrocketing enrollment and Medicaid costs, largely driven by able-bodied adults. With nearly 28 million able-bodied adults now dependent on the program—most of whom don’t work at all—the new guidance gives states new tools to move millions of Americans from welfare to work.

At least a dozen states have authorized Medicaid work requirement through state law, have waivers out of public comment, or have waivers pending with CMS. Many of these waivers already conform with the new guidance, so there should be little delay in gaining final approval from the Trump administration.

New Hampshire, for example, filed a waiver request in November to require able-bodied adults in its Medicaid expansion to work, train, or volunteer on at least a part-time basis. According to state data, a jaw-dropping 58 percent of those able-bodied adults have no earned income.

These common-sense work requirements also enjoy broad, bipartisan support. A soon-to-be-released survey found that nearly three-quarters of all voters support Medicaid work requirements. These results are consistent with prior independent surveys conducted by Harvard/POLITICO, Kaiser Family Foundation, and others.

“Today’s guidance is a critical step for the Medicaid program and millions of able-bodied adults trapped in dependency. Work is the key to their futures. With today’s guidance, states have a clear roadmap to move millions of able-bodied adults from welfare to work and preserve resources for the truly needy. We expect rapid adoption of this new option in the states,” said FGA’s CEO Tarren Bragdon. “We applaud the Trump administration’s active commitment to reducing dependency and moving Americans from welfare to work.”

The Foundation for Government Accountability is a non–profit, multi–state think tank that specializes in health care, welfare, and regulatory reform. To learn more, visit


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