Medicare-For-All Would Render Medicaid Work Requirements Unnecessary

FEATURING SOPHIA TRIPOLI - The Centers for Medicare and Medicaid (CMS) published a rule in June, ostensibly to comply with last year’s One Big Beautiful Act of 2025 requiring Medicaid recipients to prove they have worked for 80 hours a month in order to qualify for government healthcare. 

The rule takes effect in January 2027 and health advocates are warning it could exclude many who need benefits but cannot fulfill the work requirements. The new Medicaid rule is expected to result in $326 billion of cuts over ten years and 5.3 million people losing health coverage, as per one analysis.

Sophia Tripoli is Managing Director of Health Policy at Families USA, where she oversees and leads Families USA’s strategic development and framework on all aspects of its health policy priorities, including guidance on federal and state health policy. She spoke with Sonali Kolhatkar about how Medicare-for-All would render such requirements obsolete.

ROUGH TRANSCRIPT:

Sonali Kolhatkar: So let's first talk about what the so-called One Big Beautiful Act actually stipulated, and then let's compare that to what CMS issued as its rule. So Republicans have made no secret for years that they've wanted to cut government health benefits. What exactly does the One Big Beautiful Act state in terms of Medicaid and the kinds of requirements it puts on those who would be eligible? 

Sophia Tripoli: Absolutely. It is a pretty huge bill. It has a number of provisions, as you mentioned up top. In total, it cuts about a trillion dollars from the healthcare system, the vast majority of that coming from Medicaid. 

And what it does is it imposes a number of new restrictions on the Medicaid program, imposing things like Medicaid work requirements, forcing Medicaid patients to redetermine their eligibility every six months, requiring Medicaid beneficiaries to pay more cost-sharing, more costs associated with keeping their benefits, and a number of other bureaucratic sort of burdens that it places on beneficiaries to continue to prove that they are eligible for the Medicaid program. 

The bill also makes a number of very significant cuts to Medicaid funding that flows into states, cutting off some of the state's ability to generate their ability to fund the state side of the Medicaid program and places a lot of limits on the tools that states have to generate their share of funding the Medicaid program. 

In total, this means that for the Medicaid program and this bill, what it does is it's going to kick a number of people off of health insurance, it's going to reduce access to significant, really important health benefits, and it pushes the burden of financing the Medicaid program more and more on the state's shoulders to deal with the burden of having to fund greater part of the state program, and limiting the state's ability to generate some of the revenue that they need to generate to fund the program, which just means cuts. Cuts to services, cuts to benefits, and cuts to the state's ability to finance the program.