This op-ed by Sen. John Kennedy (R-La.) first appeared in National Review on February 6, 2025.
Medicaid is supposed to be an investment in our country’s health and well-being. So why doesn’t the program encourage more Americans to enter the workforce and improve their physical, mental, and financial health?
Numerous studies have shown that human beings are happier and healthier when they are employed. Long-term joblessness is associated with higher rates of cardiovascular disease, depression, and anxiety. One study even recommended employment as a “critical mental health intervention.”
Still, taxpayers today are footing the bill for an estimated 15 million able-bodied adults without children or other dependents to receive health care coverage under Medicaid without any obligation to get a job. Many of them are simply choosing not to work. Both the taxpayer and the Medicaid recipients themselves would be better off if the program had a work requirement.
Since the early 2000s, the percentage of employed Americans has steadily declined. The labor force participation rate — a figure that shows the percentage of Americans who are currently working or actively looking for work — has shrunk by 3.5 percent over the past two decades. That’s nearly 12 million Americans who have given up on working entirely.
Meanwhile, the United States had more than 8.1 million job openings as of November. If we adopt the right socio-economic policies, the number of new jobs American businesses will need to fill will skyrocket. The United States needs all Americans who can work to join our labor force.
Not only would work requirements for Medicaid encourage Americans to enter our job market, it would also help fulfill the mission of President Trump’s Department of Government Efficiency by regaining control of Congress’s Medicaid spending spree.
Nearly one in four Americans is on Medicaid today. Federal and state spending on the program has nearly doubled since 2020. Covid-19 was responsible for some of the spending surge, but there has been no effort to return Medicaid spending back to pre-pandemic levels.
This is unsustainable. Medicaid is well on its way to costing taxpayers $1 trillion per year. Congress must find a way to get able-bodied Americans back on their feet and off Medicaid. With the right incentives in place, these Americans can leave this life of poverty and dependency to set out on a pathway toward success.
A person without a job is not healthy. He’s not happy. He’s not free. Who really wants to be a slave to some government entitlement program?
Work requirements would help preserve the Medicaid program for those who really need it. The Congressional Budget Office has estimated that Congress could save the American taxpayer $109 billion over ten years by implementing work requirements for Medicaid.
The American people are the most generous people on Earth, and they are proud to help those on Medicaid who cannot work. That does not mean, however, that Congress should exploit the taxpayers’ generosity to support those who won’t work. The Jobs and Opportunities for Medicaid Act would require all able-bodied Medicaid recipients without dependents at home to work or volunteer for 20 hours per week.
Medicaid is an investment in our public health. Congress should treat it that way. Adding a work requirement to Medicaid would make the United States a stronger, healthier country and remind the world that America respects the dignity of hard work.
