One Big Beautiful Bill - Medical

 

Working Toward Accountability: The Truth About Medicaid Reform in the New Bill

As the debate around the “One Big Beautiful Bill” rages on, much of the noise has come from media spin, partisan outrage, and half-baked hot takes. But if you cut through all the hysteria and look at what’s actually in the bill, one reform stands out as a common-sense, ethical, and financially responsible move: the Medicaid work requirement.

Let’s get real about what this part of the bill actually does—and doesn’t do.

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The Myth: “People Will Be Kicked Off Medicaid!”

This claim has been echoed across social media and news outlets, but it’s flat-out misleading. The new work requirement does not apply to everyone, and it does not remove support for people who legitimately need it.

Here’s the truth:

• The requirement applies only to able-bodied adults between the ages of 19 and 64.

• It exempts:

  • People with documented disabilities

  • Pregnant women

  • Full-time students

  • Primary caregivers for disabled family members

  • Those enrolled in addiction recovery programs

  • Individuals over age 65

So if you're vulnerable or unable to work due to real circumstances—you’re still protected.

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The Requirement: 80 Hours per Month of Effort

Recipients in the target group must either:

• Work,

• Attend job training,

• Volunteer in the community, or

• Participate in approved workforce programs
  …for at least 80 hours a month—that’s just 20 hours a week.

If someone can’t manage that, and they aren’t exempt, the question becomes: why are they receiving taxpayer-funded health benefits?

This is not about punishment. It’s about engagement, dignity, and accountability.

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The Reason: A Broken System Bleeding Dollars

Medicaid was designed as a safety net, not a hammock. But over time, gaps in eligibility checks and loose accountability have created a system that’s far too easy to abuse.

This bill tightens that up by:

• Requiring eligibility redetermination every 6 months

• Reducing provider tax loopholes

• Encouraging states to enforce work requirements instead of rubber-stamping renewals

The Congressional Budget Office (CBO) estimates these reforms will save over $600 billion over 10 years—money that can either go back into better care for those who qualify or help reduce the national debt.

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The Ethics: Accountability Is Compassion

Some critics call this “cruel.” But what’s actually cruel is continuing to fund abuse and inefficiency while people in genuine need wait for help.

This reform:

• Encourages personal responsibility

• Restores public trust in government programs

• Helps connect people to work, purpose, and stability

You can’t claim to care about the vulnerable while defending a system 

that’s being drained by those who refuse to lift a finger.

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In Closing: The Work Ethic Is Not Optional

This part of the bill shouldn’t be controversial. It reflects basic values: you give what you can, you receive what you need. And for the vast majority of Americans, that’s not only fair—it’s what we’ve always believed in.

If we’re serious about protecting the integrity of public health programs, this kind of reform is not just reasonable—it’s essential.

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