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04
Jun
2025

Medicaid work requirements are the real ‘fraud and abuse’

Below is a letter to the editor written by Dr. Kendra Holmes, published in the May 29, 2025 edition of the St. Louis Post-Dispatch. 

Let’s be clear: When it comes to Medicaid, work requirements are indeed funding cuts disguised as policy. The vast majority of able-bodied adults on Medicaid are already working, often juggling multiple low-wage jobs that don’t offer health insurance.

How do I know? Because I see them every day in their work uniforms wearing their employee badges from local organizations as they access care in our health centers. They are the people keeping our restaurants running, caring for our children and elders, and cleaning our schools and hospitals. They are working, yet they still qualify for Medicaid because wages alone aren’t enough.

Work requirements, where they have been instituted in other states, have been shown not to improve health outcomes or encourage employment. Instead, they create bureaucratic red tape, procedural verification hoops that will inevitably cause thousands of eligible, hardworking people to lose coverage.

These requirements also disproportionately harm people with disabilities, family caregivers, and those navigating life in an aging population, many of whom cannot simply “go get a job” without abandoning their elderly loved ones.

As taxpayers, we want government efficiency, not policy that creates more barriers. We would welcome stronger efforts to detect actual fraud and abuse in the Medicaid program. But this isn’t that.

The real fraud is pretending these requirements have a moral component, when in reality, they punish the working poor and vulnerable under the guise of responsibility.

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