A federal study projects that Medicaid work requirements could increase family net income by $12,034 and reduce poverty for 1.6 million to 2.9 million Americans, according to a commentary published June 15, 2026 by Americans for Tax Reform. The piece examines new Medicaid work requirements released by the Centers for Medicare & Medicaid Services, which mandate that certain able-bodied adults work, volunteer, or pursue education for 80 hours per month to maintain benefits. The analysis argues these requirements will restore Medicaid's original purpose while relieving taxpayer burden and promoting economic growth.
The commentary cites several striking data points about Medicaid's current state. Federal Medicaid programs cost $12,100 per beneficiary, paid by American taxpayers, and roughly 62% of able-bodied adults on Medicaid aren't working, volunteering, or getting an education. Perhaps most notably, 35.9% of all Medicaid spending now goes to able-bodied adults—a plurality of total program costs. The piece notes that federal taxpayers now spend more on Medicaid for able-bodied adults than they do for seniors, individuals with disabilities, and children combined. Under the new interim rule, states must require documentation to prove "medically frail" status starting January 1, 2028, though they may accept self-assessment through 2027 when reliable data isn't available.
According to the commentary, the reform will reduce Medicaid spending by $325 billion, as reported by the Cato Institute, which allowed Congress to cut taxes for everyday Americans. The authors write that an able-bodied adult would only need to work 19 hours per week at the average entry-level wage of more than $15 per hour to lift themselves above the poverty line. The Office of the Assistant Secretary for Planning and Evaluation calculated that if states effectively implement these requirements, they'll significantly reduce poverty by promoting economic growth and labor force participation.
The commentary points to existing work requirements as proof the policy works. Research from the National Evaluation of Welfare-to-Work Strategies found that work requirements increased employment by 4.2 percentage points in the first five years for Temporary Assistance for Needy Families recipients. A study in Charlotte, North Carolina showed even more dramatic results: enforcing work requirements for public housing residents at just 15 hours per week raised the employment rate from 58% to 88%. Food stamp work requirements led able-bodied adults to join the workforce in more than 1,000 industries, doubling their previous incomes within a year and tripling them within two—with higher wages offsetting any lost welfare benefits. The commentary explains that these examples demonstrate work requirements create a positive cycle: people leave welfare, enter the workforce, earn more money, and begin contributing to the economy rather than drawing from it.
The authors conclude that Medicaid was designed as a temporary bridge for pregnant women, the disabled, and children, but has been "abused by able-bodied adults who are capable of employment." They argue the Working Families Tax Cut of 2025 and the new CMS guidance will deliver relief to American taxpayers, reduce poverty, and restore Medicaid's original intent. The bottom line: work requirements don't just save money—they lift people out of poverty and into economic participation.