Seema Verma, the Trump-appointed administrator of the Centers for Medicare & Medicaid Services, has announced that the federal government will support state efforts to add work requirements to Medicaid, which provides health care and support services to poor and disabled Americans.

States will almost certainly take them up on this offer. Already, there is a state waiver request pending from Kentucky requesting permission to impose work requirements as a condition of Medicaid eligibility, and Arizona and Arkansas have expressed interest as well.

A Medicaid work requirement would be a huge departure from current practice, and a move that even many conservatives disagree with. It’s also likely to be ineffective, difficult to enforce, and maybe even illegal.

“I feel some sympathy for people who are saying, ‘This is my money, I’m working, I want to make sure other people who get support are working,’” says Gail Wilensky, who ran the Centers for Medicare and Medicaid Services in the George H.W. Bush administration. “But I’m not sure when you actually look where this has been tried, it’s had much effect.”

The majority of people benefiting from Medicaid are children, disabled, or elderly, and would be exempt from work requirements. If you exclude pregnant women and parents with young children, the number of affected people shrinks even more. The majority of the remaining non-disabled adults are working. And some of them can only work because they get Medicaid — such as people who have mental illnesses or struggle with substance abuse but who, with reliable health care, are healthy and stable enough to work. Making work a prerequisite for Medicaid could, perversely, wind up preventing such people from working.

“It would really harm people least able to hold and keep a job and hurt people who need health care to participate in the workforce,” Hannah Read More Here