Republican lawmakers are rallying behind a key provision in President Trump’s sweeping “Big Beautiful Bill” that would require certain adults to work or participate in approved activities in order to qualify for Medicaid.
The rule, which is drawing fierce criticism from Democrats, mandates that able-bodied adults without dependents between the ages of 18 and 64 work at least 80 hours per month—or meet the requirement through school, community service, or job training—to maintain Medicaid eligibility.
“We’ve got to get back to work,” said Sen. Tommy Tuberville (R-Ala.), who voiced strong support for the measure. “It’s just unfortunate—you’ve got a lot of freeloaders in this country.”
Sen. Roger Marshall (R-Kan.) told Fox News Digital that work brings dignity and purpose. “We want people to go to college, volunteer, or work 20 hours a week. There’s value in that. It’s nothing to be ashamed of.”
Marshall pointed to labor shortages as justification, citing data showing seven million able-bodied men of working age currently unemployed. “And we have about seven million job openings. Let’s help connect those dots,” he said.
Sen. Bill Hagerty (R-Tenn.) argued the system is being abused. “The disincentives to work are a real problem here in America,” he said. “Taxpayers shouldn’t be covering able-bodied individuals—and certainly not non-citizens.”
Tuberville blamed a cultural shift among younger Americans. “They’re loaded with student debt, can’t find jobs with useless degrees, and now they expect the government to support them,” he said. “That’s socialism. We’ve got to end it.”
Sen. Ron Johnson (R-Wis.) also backed the requirement, tying it to broader concerns about government overreach. “Let’s be honest—this isn’t just Medicaid. It’s part of Obamacare’s attempt to shift us toward a single-payer system,” Johnson said, claiming states have come to rely on funding tied to “legalized fraud.”
But Democrats say the requirement is less about promoting work and more about stripping health coverage from millions.
Sen. Chris Murphy (D-Conn.) called it a calculated move to shrink the Medicaid rolls. “This isn’t about efficiency—it’s about kicking people off health care,” he said. “It’s designed so people will fail to meet the requirements, even if they’re working.”
Sen. Mark Kelly (D-Ariz.) warned the provision could leave as many as 17 million Americans without health coverage, including 300,000 of his own constituents. “These are real people making impossible choices—between rent, food, and seeing a doctor.”
While some Democrats, like Sen. John Fetterman (D-Pa.), agreed that fraud should be addressed, most were sharply critical of the work requirement.
James Agresti, president of the conservative think tank Just Facts, pushed back against Democratic concerns, calling them exaggerated. “The idea that able-bodied adults can’t work, study, or volunteer 20 hours a week is ridiculous,” he said.
Agresti cited Congressional Budget Office estimates suggesting the new rule would remove about 10.6 million people from Medicaid, including 1.4 million non-citizens and 9.2 million who refuse to work or commit fraud.
A spokesperson for Sen. Kelly disputed that interpretation, pointing to revised projections showing up to 17 million could lose coverage by 2034 when combining the work requirement with other provisions in the bill.
Agresti countered that these projections are misleading, noting that the bill doesn’t repeal expanded Obamacare subsidies outright but phases out temporary COVID-era boosts.
He also pointed to a bipartisan consensus that work disincentives have become a long-term issue. “Even Lawrence Summers, former Obama advisor, has acknowledged that government assistance can discourage work,” he said.
The Medicaid work rule is just one element of Trump’s massive bill, which also includes tax cuts, asylum reforms, and sweeping changes to federal programs. While Republicans tout it as a return to American values, Democrats warn it could upend the safety net for millions.Tools
