Treasury Secretary Scott Bessent defended the controversial work requirements tied to Medicaid in President Donald Trump’s newly signed domestic spending bill, accusing Democrats of insulting low-income Americans by opposing the changes.
“It’s a group of Democrats who, unfortunately, seem to think that poor people are stupid,” Bessent said Sunday on CNN’s State of the Union. “I don’t think poor people are stupid. I think they have agency. And I think asking them to register twice a year for benefits is not a burden.”
Bessent accused critics of “infantilizing” Medicaid recipients and overhyping the impact of the requirements, which mandate many able-bodied adults to prove they are working, attending school, or volunteering at least 80 hours per month in order to keep coverage.
The new work requirements are a key element of Trump’s sweeping “megabill,” which was signed into law Friday and includes over $1 trillion in health care spending cuts. The savings are intended to help offset the cost of extending Trump’s signature tax cuts, originally passed in 2017.
But Democratic leaders, health care advocates, and state officials argue the requirements will create needless bureaucratic hurdles for vulnerable populations — and jeopardize access to care.
Kentucky Governor Andy Beshear fired back at Bessent’s remarks during a separate interview on State of the Union, defending Medicaid recipients in his state.
“I know a lot of people on Medicaid,” Beshear said. “These are parents with special needs children who could never afford care otherwise. They’re already working two jobs. If they miss a deadline or fail to check a box, they could lose coverage. You can lie all you want about what’s in this bill, but the numbers are the numbers.”
Health policy experts have also raised red flags. Dr. Richard Besser, president and CEO of the Robert Wood Johnson Foundation, pointed to Arkansas as a cautionary tale. When that state implemented similar work requirements, thousands lost their Medicaid coverage.
Speaking on ABC’s This Week, Besser warned of broader consequences beyond individual coverage losses.
“It’s not just the people losing insurance — it’s also rural hospitals,” Besser said. “They rely on Medicaid funding to survive. If these cuts go into effect, hundreds of rural hospitals could shut down. And that impacts entire communities. Businesses don’t want to invest in towns without hospitals.”
Bessent argued that the administration’s economic policies — including job creation and border security — will offer Medicaid recipients the chance to transition into full-time employment with employer-provided benefits.
“There’s no change in benefits — just a change in how you qualify,” he said. “We’re bringing back manufacturing and working-class jobs. Wages are rising. We’re creating opportunities for people to move off Medicaid and into jobs with good health care.”
