The traditional Medicaid program began in 1965 and was designed as a health insurance entitlement for low-income families with children, for disabled people, and for some long-term care. Unlike Medicare, Medicaid is funded, and to a certain extent managed, by both the federal and state governments. Both enrollment and cost have exploded since the entitlement began. (here)

Obamacare expanded Medicaid to any low-income adult 18 to 64 years of age. Nationally, approximately 10 million Americans have enrolled in the expanded Medicaid.

The Trump Administration is now accepting, and actually encouraging, states to apply for Obamacare 1115A waivers to customize their Medicaid programs. (here) One of the most controversial waiver requests is for a work requirement. There has never been a formal work requirement in Medicaid. It was actually part of the original welfare reform legislation of the Clinton Administration, but was removed before the welfare changes were made.

Although the numbers are elusive, it is safe to say that some percentage of the new Medicaid enrollees are able-bodied and could hold down a job. In addition, satisfying the work requirement includes community service and/or further education. None of the waiver requests would force disabled or enfeebled individuals to find a job or lose Medicaid.

The political left finds the work requirement too onerous. The left is saying that even if low-income people can hold down a job, can improve their position in life, and can find a pathway off the government entitlement, they should not be given that opportunity.

The political left also argues that low-income people will decline to enroll in Medicaid because of the work requirement and will go uninsured. This begs the question – why would anyone not sign up for free health insurance? Likewise, do taxpayers have the right to ask recipients of a free entitlement to give back something to society?

A job gives a person a sense of self-accomplishment and self-worth. A work requirement for the able-bodied enrolled in Medicaid provides an escape route from the welfare entrapment.