Debunking the Myths of the One Big Beautiful Bill
Correcting the Record on Community Engagement Requirements
Myth: The OBBB community-engagement requirements will kick millions of workers off Medicaid.
Fact: The Congressional Budget Office estimates that nearly five million able-bodied, working-age adults will not meet the work and community-engagement requirements. Unfortunately, a large and growing number of able-bodied, working-age individuals, particularly men, have chosen not to work or look for work. Time-use surveys suggest that many Medicaid expansion enrollees are spending large amounts of time watching television, playing video games, and sleeping ten or more hours a day. The Centers for Medicaid and Medicare Services is committed to working with states to ensure that eligible enrollees who satisfy the community-engagement requirements remain covered in Medicaid.
Myth: Children and the disabled will be kicked off Medicaid due to the work requirements.
Fact: The community-engagement requirements only apply to able-bodied, working-age adults who do not have children age 13 or younger and who are enrolled under Obamacare’s expansion. In households with children age 14 or older, eligible children will still be enrolled in the program even if their parent do not meet the community-engagement requirements.
Myth: People will not be able to find jobs and will lose Medicaid eligibility as a result.
Fact: The legislation allows for exemptions from the community-engagement requirements in areas with high unemployment. Additionally, there are numerous avenues for individuals to satisfy the 80-hour-a-month community-engagement requirements. This includes volunteering, work training, attending school, or any combination of these activities for a total of 80 hours a month.
Myth: Two-thirds of able-bodied, working-age adults on Medicaid already work, so we do not need these requirements.
Fact: A significant number of the 20 million able-bodied working-age adults that have Medicaid through the ACA expansion do not work or meet other community-engagement criteria. Allowing able-bodied, working-age adults to receive benefits without satisfying community-engagement requirements is unfair to those able-bodied, working-age adults on Medicaid who work as well as the most vulnerable who most need the program.
Myth: OBBB just punishes the poor.
Fact: President Clinton, when signing the 1996 welfare to work law, clearly articulated that a system that traps people on welfare is what punishes the poor.
“Nearly 30 years ago, Robert Kennedy said, ‘‘Work is the meaning of what this country is all about. We need it as individuals, we need to sense it in our fellow citizens, and we need it as a society and as a people.’’ He was right then, and it’s right now. From now on, our Nation’s answer to this great social challenge will no longer be a never-ending cycle of welfare, it will be the dignity, the power, and the ethic of work. Today we are taking an historic chance to make welfare what it was meant to be: a second chance, not a way of life.”
The vast majority of Americans agree with these remarks today. More than two of three Americans believe that “Medicaid should be a temporary safety net, not a long-term entitlement for those who are able to work. Encouraging this population to work would improve their personal situation and help get them off Medicaid, saving money that could be directed toward those who need it most—children, seniors, and people with disabilities.”
Working leads to better health. The Robert Wood Johnson Foundation has found unemployment leads to worse health outcomes and increases in stress related conditions such as strokes, heart attacks and arthritis. It also found that unemployment increases the incidence of depression.
Myth: Seasonal workers will not be able to comply because their work schedules vary.
Fact: Seasonal workers will meet the requirements if their average monthly income over the past six months is at least equal to the minimum wage for 80 hours of work per month.
Myth: As previous attempts at work requirements show, they are impossible to administer.
Fact: The federal government has had work requirements for federal welfare programs since 1996, when President Clinton signed the Personal Responsibility and Work Opportunity Reconciliation Act, otherwise known as welfare reform.
Previous state-level attempts to implement work requirements, which are often cited by critics of the policy, were done on an ad hoc basis through state waiver requests. Supporters of the ever-expanding welfare state fought against work requirements and sued the state, making implementation more difficult. Now, instead of relying on one-off waivers, the Centers for Medicare and Medicaid Services will provide states with implementation guidance, technical assistance, and model programs.
States will also be eligible to receive implementation grants to build the necessary systems. This assistance was not available to those states that previously attempted to implement work requirements through a waiver.
Finally, technology has progressed significantly since 2018. Information tools and platforms to administer these requirements have advanced, and what was once seen as futuristic—like Artificial Intelligence—is now a promising frontier for every sector of the U.S. economy.
Background
The One Big Beautiful Act institutes community-engagement requirements for able-bodied, working-age adults who do not have children younger than 14 and who are enrolled under Obamacare’s expansion. These requirements can be satisfied through working 80 hours a month. Alternatively, the requirements can be satisfied through volunteering, job training, or going to school.
The OBBB provides exemptions from the requirements to ensure they are directed at individuals who can satisfy them. These exemptions include:
- Parents, guardians, and family caregivers of disabled individuals or children age 13 or younger,
- Medically frail individuals or those with special medical needs,
- Individuals participating in drug addiction or alcoholic treatment and rehabilitation programs, and
- Individuals that satisfy the Supplemental Nutrition Assistance Program work requirements.
