Source: Politico
Democrats aggressively oppose all elements of a Republican proposal to overhaul Medicaid as a way to cut spending — but they are now zeroing in on the specific proposal to make work requirements a condition of qualifying for the program.
The messaging tactic was crystallizing in the early morning hours of Wednesday, as the House Energy and Commerce Committee continued its marathon markup of its portion of the GOP’s larger party-line package of tax cuts and extensions, border security investments, energy policy and more.
“What I believe you’re doing, not intentionally, is figuring out every way possible for them not to qualify, either because they can’t fill out the paperwork [or] they don’t know how to do it,” said committee ranking member Frank Pallone (D-N.J.) to Republicans of the effect of their policies on Medicaid recipients.
The work requirement proposal being considered would produce the biggest savings of any other policy in the House Energy and Commerce Committee’s draft bill, accounting for nearly $301 billion over a decade, according to a Congressional Budget Office estimate released by panel Republicans. That level of savings is even higher than many people had anticipated, indicating there would be significant uninsured rates as a result of the policy: The CBO estimated that the Medicaid portions would lead to 7.6 million people losing Medicaid benefits.
Other Democrats also made the case that the work requirements amounted to paperwork requirements. Health subcommittee ranking member Diana DeGette (D-Colo.) pointed to KFF data showing that among adults on Medicaid not getting Social Security or Medicare, 92 percent worked full- or part-time. She argued it would lead to major coverage losses, including among patients who are eligible for exemptions due to those very same paperwork burdens.
“You can’t just cut $715 billion in Medicaid without slashing benefits for people,” DeGette said, referring to the preliminary CBO estimate of the savings expected to be achieved through the health policy portions of the GOP megabill.
Energy and Commerce Chair Brett Guthrie (R-Ky.) said Republicans have learned lessons from previously attempted work requirements in Arkansas, including the advantages of avoiding “overly cumbersome” monthly checks.
“We don’t want to repeat the Arkansas model,” Guthrie said, detailing a laundry list of exemptions.
Rep. Alexandria Ocasio-Cortez (D-N.Y.) shot back that Republicans have also looked to Georgia’s Medicaid work requirements in the program to help inform the bill, noting the state has “the third most catastrophic uninsured American number in the country.”
“They are modeling and completely retrofitting the United States’ Medicaid system to model it after [Georgia] in the dead of night, at 2:38 in the morning, when everyone is asleep, when we’ve asked for the opportunity to do this in the light of day, so people can call their representatives’ offices in order to stop this disaster,” she continued.
The proposal would also bar people who are eligible for Medicaid but don’t meet the work requirements from getting subsidized Affordable Care Act marketplace coverage, which Democrats slammed.
“[Guthrie’s] saying that you’re kicked off because you refuse to work. Our argument on the Democratic side is you’re kicked off because you didn’t meet the red tape requirements,” Pallone said.
Amid the back and forth, Rep. August Pfluger (R-Texas) said the work requirements would merely prevent able-bodied adults who don’t want to work from getting coverage. He asked Rep. Raul Ruiz (D-Calif.) if he thought there should be any sort of work requirement to get Medicaid benefits.
“No. That’s an easy one,” Ruiz said.
After hours of debate, Republicans in unison voted down a Democratic amendment that would have required the Health and Human Services secretary to certify that the GOP bill would not reduce any Medicaid benefits offered by states, pointing to President Donald Trump’s repeated pledges to protect the program.
“We will not touch essential health care services for vulnerable populations,” said health subcommittee Chair Buddy Carter, a Georgia Republican who recently launched a bid for Senate in 2026.
Democrats also early Wednesday morning pushed back against GOP plans to limit taxes that states levy on providers to help fund their Medicaid programs, which could force states to make major changes to how they finance their programs or cut benefits. The proposal, which the CBO estimated would save about $87 billion, would freeze state provider taxes at their current rates and prohibit them from establishing any new taxes.
“Provider taxes are the backbone of our Medicaid financing system,” said Democratic Rep. Marc Veasey of his home state of Texas. “This isn’t a loophole — it is a congressionally sanctioned mechanism that is used responsibly by 49 out of 50 states.”
“This is federal overreach, plain and simple, with devastating consequences for the people we represent,” added Rep. Lori Trahan (D-Mass.).
Republicans said that states use the taxes to boost their federal share of Medicaid payments without having to use their own revenue, frequently accusing local jurisdictions of “money laundering” by gaming the system to draw down more federal dollars. Some Democrats, including former President Barack Obama, have proposed reining in the taxes.
“This is a huge wart on our Medicaid system,” Rep. Jay Obernolte (R-Calif.) said. “It creates all kinds of perverse incentives and rewards the states that are willing to be the most abusive.”
