Republicans defended the Trump-backed megabill’s Medicaid changes as targeting a group of people who they believe shouldn’t qualify: people who can work but instead choose to stay home and chill.
Several Republican politicians and pundits, including CNN senior political commentator Scott Jennings, pegged the number of people who should be able to meet the proposed Medicaid work requirement at about 5 million.
“There are like almost 5 million able-bodied people on Medicaid who simply choose not to work,” Jennings said July 1 on “CNN NewsNight with Abby Phillip.” “They spend six hours a day socializing and watching television. And if you can’t get off grandma’s couch and work, I don’t want to pay for your welfare.”
Medicaid is the federal-state health insurance program that covers medical care for lower-income people.
Jennings cited two pieces of data: an estimate of how many people would lose coverage because of the work requirement, and an analysis of how nonworking Medicaid recipients spend their time. But he made assumptions that these sources don’t support.
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Jennings misrepresents CBO estimate on ‘able-bodied’ people who would lose coverage
The 4.8-million figure stems from a June 24 Congressional Budget Office analysis about the House version of the massive tax and spending package. The office, which is Congress’ nonpartisan research arm, projected that the bill would cause 7.8 million people to lose health coverage by 2034. That would include 4.8 million Medicaid recipients who are described as “able-bodied” adults between 19 and 64 who have no dependents and who “do not meet the community engagement requirement” of doing “work-related activities” at least 80 hours a month.
Apart from work, community service and school also fulfill the community engagement requirement.
Jennings paired that statistic with a separate analysis of how “nondisabled,” childless adult Medicaid recipients spend their time.
But the CBO estimate was a projection — it doesn’t represent the current number of able-bodied Medicaid recipients, nor does it say 4.8 million people in this group “choose not to work.” The figure represented how many people could lose coverage because of the bill’s community engagement requirement.
“The challenge with Jennings’s comments — and they’ve been echoed elsewhere by elected Republicans — is that CBO never said that 4.8 million people were out of compliance with the proposed work requirements; they said that 4.8 million people would lose coverage because of the work requirements,” said Adrianna McIntyre, Harvard T.H. Chan School of Public Health assistant professor of health policy and politics.
The law requires adults without child dependents and parents of children older than 13 to work 80 hours every month. The state would need to verify that applicants met the work requirement in the one to three months before they applied. The state would also be required to verify that existing enrollees met the work requirement for at least one month between eligibility determinations (which happen at least twice a year).
Research into Medicaid work requirements imposed at the state level, has shown that people found it difficult to fulfill such requirements and documentation, contributing to coverage losses.
In Arkansas, which added a work requirement for Medicaid in 2018, a study based on 6,000 respondents found that almost 95% of the target population were already working or qualified for an exemption, but a third of them did not hear about the work requirements. As a result, 17,000 Medicaid recipients who were subject to work requirements lost coverage.
Kff found that adults ages 50 to 64 are more at risk for losing Medicaid coverage because of the new work requirements. More than 1 in 10 in that age group said they retired, and among them, 28% reported being disabled, KFF said.
Benjamin Sommers, Harvard T. H. Chan School of Public Health health care economics professor, said many of the 4.8 million “able-bodied” people in the CBO estimate “will actually be engaged in the activities they are supposed to be doing, and lose coverage because they are not able to navigate the reporting requirements with the state and lose coverage from red tape.”
Few ‘able-bodied’ Medicaid recipients don’t work because they choose not to, research shows
There is no singular definition for “able-bodied”; disability can be assessed in different ways. But other Medicaid research studies offer much smaller estimates than Jennings’ 4.8 million of Medicaid recipients without dependents who can work but choose not to.
Millions of non-retirement age, non-disabled adults joined the Medicaid ranks in states that expanded eligibility under the Affordable Care Act. There were about 34 million working-age nondisabled Medicaid enrollees in 2024, according to CBO15 million of whom enrolled through the ACA.
A KFF Analysis found a smaller figure of 26 million for Medicaid-covered adults, ages 19 to 64, who don’t receive Supplemental Security Income or Social Security Disability Insurance benefits and are not Medicare-covered.
Among this group, KFF estimated 64% were working either full time or part time. The reasons why the rest were not working included caregiving (12%), illness or disability (10%), retirement, inability to find work or other reason (8%) and school attendance (7%).
Few people cited lack of interest in working as the reason for their unemployment. An Urban Institute study found 2% of Medicaid expansion enrollees without dependents who neither worked nor attended school — or 300,000 people out of a projected 15 million subject to work requirements — cited a lack of interest in working as the reason they’re unemployed.
This was consistent with the Brookings Institute’s June 5 analysis, which found that out of 4.3 million adults who worked fewer than 80 hours a month and did not have any activity limitations or illnesses, about 300,000 reported that they “did not work because they did not want to.”
Most able-bodied Medicaid recipients who don’t work are women and have a high school education or less, research shows
When Republicans have described the able-bodied adult Medicaid recipient, they often portray this person as a man in his 30s who “plays video games” or “smokes weed all day.” Research paints a different picture.
Jane Tavares and Marc Cohen, who teach at the University of Massachusetts Boston Gerontology Department, researched Medicaid recipients who are able-bodied, not working, have no child dependents and are not in school. They cited 2023 U.S. Census data from the American Community Survey.
They found the following:
“They are not healthy young adults just hanging out,” the authors, along with health law experts Sara Rosenbaum and Alison Barkoff, wrote April 30.
“It’s clear based on their prior work history and family size/income that they are exceptionally poor and have likely left the workforce to care for adult children or older adults,” Tavares told PolitiFact. “Even if these individuals could work, they would have very few job opportunities and it would come at the cost of the people they are providing care for.”
American Enterprise Institute study not definitively linked to CBO estimate
On XJennings posted the CBO letter and a May 29 analysis by the American Enterprise Institute, a conservative think tank, about “how nondisabled Medicaid recipients without children spend their time.” PolitiFact contacted CNN to reach Jennings but did not receive a reply.
The author of that study, American Enterprise Institute senior fellow Kevin Corinth, analyzed survey data and found that Medicaid recipients who do not report working spend on average 6.1 hours a day “on all socializing, relaxing and leisure activities (including television and video games).”
But it’s uncertain whether the people in the survey population he analyzed overlap with the people included in the CBO analysis, said Jennifer Tolbert, deputy director of KFF’s Program on Medicaid and the Uninsured and the director of state health reform.
Corinth told PolitiFact “it is difficult to say” how the population he analyzed differs from the CBO projection. Tavares, Cohen, Rosenbaum and Barkoff said Corinth’s dataset defined disability narrowly, leading to a “serious underestimation of disability” among the population of Medicaid recipients he looked into. It focused on people who receive Supplemental Security Income under Medicaid or people with a health condition that prevents them from working. Researchers said this approach is too narrow, because the SSI program accounts for only those “most deeply impoverished adults with severe disabilities.”
The group gave a hypothetical example of a 54-year-old woman with a serious heart condition who can only work a few hours each week. She may not be considered disabled under the SSI program, but she may be limited in terms of employment and may need time to rest.
“Using her ‘leisure time’ to justify a work requirement grossly misrepresents her reality,” the group said.
Corinth’s analysis also shows that nonworking Medicaid recipients spend less time socializing, relaxing or engaged in leisure activities than nonworking people who aren’t covered by Medicaid. Nonworking Medicaid recipients also spend more time looking for work and doing housework and errands.
Our ruling
Jennings said there are 5 million able-bodied Medicaid recipients “simply choose not to work” and “spend six hours a day socializing and watching television.”
The 5 million figure stems from a CBO projection that 4.8 million people would lose coverage as a result of not fulfilling the community work requirements through 2034. It is not descriptive of current enrollees and it does not specify that these people choose not to work.
Jennings cited an American Enterprise Institute analysis on how nondisabled Medicaid recipients with no dependents spend their time, but it is uncertain if the population in that analysis overlaps with those in the CBO estimate.
Current snapshots of the population Jennings described produce a smaller number. A survey by the Urban Institute found that 2% of nonworking Medicaid expansion enrollees without dependents, or about 300,000, cited a lack of interest in working. Other research shows reasons why this group doesn’t work include caregiving, illness or disability, retirement, inability to find work and school attendance.
Studies of nonworking Medicaid recipients have found the majority are women and have a high school education or less. The average age is 41, and more than half have a work history in the past five years.
We rate Jennings’ statement False.
