House Republicans' debt bill includes Medicaid work requirements

House Republicans have unveiled their plan to address the national debt, and it includes a longtime GOP health priority: work requirements in Medicaid.

The bill would not include cuts to Social Security or Medicare to address the debt ceiling but does target Medicaid. The bill would require people on Medicaid to work, look for a job or participate in "community engagement" activities for at least 80 hours per month.

House Speaker Kevin McCarthy, R-California, said the measure would "help lift millions of Americans out of poverty."

“Our plan ensures adults without dependents earn a paycheck and learn new skills," McCarthy said. "By restoring these common-sense measures, we can help more Americans earn a paycheck, learn new skills, reduce childhood poverty and rebuild the workforce."

Republicans' interest in work requirements isn't new. Policies were championed by officials within the Trump administration, and the Centers for Medicare & Medicaid Services approved waivers in 10 states that wanted to roll out work requirements programs. 

However, these largely failed to take off, with several states' initiatives blocked in court. Arkansas was the only state to fully launch such a program in 2018, and a 2020 Health Affairs analysis found that its program did not lead to an increase in work.

The Congressional Budget Office estimated that work requirements could indeed drive significant savings, decreasing federal spending by about $135 billion between 2023 and 2031 because 2.2 million people would lose Medicaid coverage.

The debt plan is likely dead in the water should it reach the Democrat-controlled Senate.