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Press release
January 11, 2018

America Moves Further Away from our Nation’s Core Values as the Trump Administration Approves Radical Changes to Health Care for Vulnerable Families

Washington, D.C. – Today, the Center for Medicare and Medicaid Services (CMS) issued a letter to State Medicaid Directors, informing them that CMS will allow Medicaid eligibility to be based on work status or “community engagement” – unpaid volunteer work. This is a radical shift in CMS policy that violates federal law and is part of an ideological agenda that is hostile to government assistance with health coverage.

Following is the statement of Eliot Fishman, senior director of health policy of Families USA:

“CMS’s decision to allow Medicaid eligibility to be based on work status is another example of the Trump administration walking away from our nation’s core values. This is the latest blow in a continuing campaign to undermine and attack the Medicaid program.

“It is telling that both the Trump administration and the states proposing work requirements also have proposed major cuts to Medicaid that would take away coverage from millions of people. Today’s announcement isn’t about work: it is about taking away health insurance from low-income people.

“Linking Medicaid’s health coverage to work status is contrary to Medicaid law. That CMS has taken it upon itself to rewrite Medicaid law under the ‘Demonstration Projects’ statute is a shocking abuse of administrative authority. For those who cannot find work, requiring unpaid volunteer work in exchange for health coverage is unconscionable legally and morally, recalling the days of work houses for the poor. Today’s decision will likely be challenged in the federal courts. Families USA is working closely with the National Health Law Program and others to support those legal challenges. Many lives are at stake if today’s CMS decision stands—we will be working to ensure that it does not.”

View Families USA's 50-state map showing which states have requested Medicaid waivers that include work requirements.

Blog: Six Reasons Work Requirements in Medicaid Are a Bad Idea.


Families USA, a leading national voice for health care consumers, is dedicated to the achievement of high-quality, affordable health care and improved health for all.