When Congress passed, and President Donald Trump signed, the “One Big Beautiful Bill Act,” work requirements for able-bodied individuals on Medicaid were among the changes enacted.

Under the legislation, able-bodied adults who have no children and are between the ages of 19 and 64 are required to complete at least 80 hours per month of work, volunteering, education, or job training to maintain Medicaid eligibility.

Numerous groups are exempted from the work requirement, including parents, guardians, caretaker relatives of dependent children, disabled family members, individuals with disabilities, people with substance use disorders and serious medical conditions, veterans with disabilities, and former foster youth.

Even with all those exemptions, the work-requirement provision is expected to reduce Medicaid enrollment nationwide and restrain taxpayer costs significantly over the next decade as millions of current beneficiaries leave the program because they have achieved earnings sufficient to no longer need taxpayer support, or because they chose to leave the program rather than work.

Watching Television, Playing Video Games

Kevin Corinth, a senior fellow at the American Enterprise Institute, has estimated that between 40 percent and 56 percent of childless, non-disabled Medicaid recipients aged 19–64 would have failed to meet the work requirement if it had been in place in 2022.

Corinth’s research examined data from the American Time Use Survey (ATUS) as well as the Current Population Survey Annual Social and Economic Supplement (CPS ASEC), which asks about health insurance coverage two to five months before individuals received the time-use survey.

Corinth found that among Medicaid recipients who did not report working, individuals typically spent 4.2 hours per day watching television and playing video games, or 125 hours during a 30-day month. That is more than 50 percent higher than the 80 hours of required work or volunteer activity.

Overall, Corinth found those Medicaid beneficiaries spent on average 6.1 hours per day, or 184 hours per month, on all socializing, relaxing, and leisure activities (including television and video games). In contrast, those individuals spent just 22 minutes a day looking for work, four hours doing housework and errands, and 28 minutes caring for others.

‘Anyone Who Can Go to Work Must Do So’

In 2020, by an extremely narrow margin, Oklahoma voters opted to expand the state’s Medicaid program to provide medical welfare benefits to certain able-bodied adults.

An April report from the Oklahoma Health Care Authority, which administers the Medicaid program, shows that 229,154 able-bodied adults in Oklahoma are enrolled in Medicaid due to expansion. That group will be the most impacted by work requirements.

The work requirements imposed for Medicaid beneficiaries are similar to work requirements imposed on food-stamp and other welfare recipients in the 1990s during the presidential administration of Democrat Bill Clinton, who campaigned vowing to end welfare “as we know it.”

In a 1996 speech touting reform, Clinton declared, “Today I am taking the steps that I can take as president to advance the central premise of welfare reform, one that is embodied in all the proposed welfare bills, that anyone who can go to work must do so. We’ll say to welfare recipients, ‘Within two years you’ll be expected to go to work and earn a paycheck, not draw a welfare check.’”

At the time, critics decried the welfare work requirements and other restrictions and predicted 2.6 million people, including 1.1 million children, would be thrown into poverty as a result of losing eligibility.

But in 2016, when the Cato Institute reviewed the impacts of the 1990s welfare reform Clinton championed, Michael D. Tanner noted, “The dire predictions of welfare reform’s critics have not come to pass. Poverty rates actually declined in the years immediately following the passage of welfare reform, as did poverty for important subcategories such as African Americans and children.”

Welfare enrollment declined from 13.42 million food-stamp recipients in 1995 to 4.12 million in 2015.

Despite that record, Democrats nationwide are again predicting doom from imposing work requirements, this time on Medicaid recipients, highlighting the large gap that exists between the Democrats of 2025 and those in power in 1996.

Oklahoma Democrats Decry Medicaid Changes

Democratic members of the Oklahoma Legislature are among those criticizing Medicaid reform.

In a press release issued prior to the passage of the new law, state Democrats decried changes to Medicaid. House Democratic Leader Cyndi Munson, D-Oklahoma City, said the state’s Republican congressional delegation was “cutting our health care and actively going against the needs of Oklahomans.”

House Democratic Caucus Assistant Leader Rep. Melissa Provenzano, D-Tulsa, said the new law “could have a potentially catastrophic impact on the Oklahoma economy” and “result in thousands of lost jobs and lost health care services across all Oklahoma communities, big and small. All to give a tax cut to the wealthiest earners.”

Oklahoma Congressional Republicans Praise Reform

But members of the Oklahoma congressional delegation voted for and hailed passage of the new law, including its changes to welfare programs like Medicaid.

“Despite the dishonest fearmongering campaign being pushed by Democrats and the far-Left media, the One Big Beautiful Bill Act will strengthen, secure, and sustain Medicaid by reestablishing it as a program that provides vital healthcare to the most vulnerable Americans and stopping the subsidization of illegal immigrants and competent adults who are just choosing not to work,” said U.S. Rep. Tom Cole, a Moore Republican who is chair of the U.S. House Appropriations Committee.

In a Newsmax interview, U.S. Rep. Kevin Hern, R-Tulsa, also touted Medicaid work requirements.“

“It’s very popular: 80-plus percent of Americans, Republican and Democrat, think you should work if you’re going to get benefits,” Hern said. “We should measure our success with our social programs about how many people we get into a job and get on to sustainability of life as opposed to depending on the federal government.”

In an interview on Fox News, U.S. Sen. James Lankford, R-Oklahoma City, addressed the addition of a work requirement for Medicaid enrollment.

“We want people that are sitting at home, that are able to work, that are able-bodied with no children that are on Medicaid, we want them to be able to get up and work,” Lankford said. “It’s good for them. It’s good for the community. It’s good for the country.”

He also defended the new law’s Medicaid changes in a video posted to X.

“It adds a work requirement to Medicaid, the same kind of work requirement that Bill Clinton put in for the social-safety net in 1996,” Lankford said. “It’s put in that same kind of work requirement in Medicaid. Now, it’s not for disabled children or pregnant moms. It’s for able-bodied adults with no children.”

U.S. Rep. Stephanie Bice, R-Oklahoma City, also pushed back against critics’ attacks on Medicaid reform.

“The fear-mongering from Democrats on the Big Beautiful Bill has been over the top,” Bice wrote in a tweet that provided a link to an editorial from The Wall Street Journal that rebutted Democrats' claims of Medicaid cuts.

The Journal editorial noted the Congressional Budget Office had predicted that “4.8 million won’t comply with the bill’s part-time work requirement. That should be a warning about the country’s social condition. The work requirement doesn’t apply to anyone who is disabled, pregnant, or caring for a child younger than age 14. Volunteering 20 hours a week or enrolled in school? You can get Medicaid.”

Another Oklahoma lawmaker touted the general welfare reforms in the bill, which included work requirements for Medicaid.

“The House Freedom Caucus fought to make this bill better at every stage—and we succeeded,” said U.S. Rep. Josh Brecheen, R-Coalgate. “We secured transformational wins for fiscal responsibility, border security, energy independence, welfare reform, and tax relief. We secured significant commitments on continuing to move the ball forward on the American First agenda, and thanks to President Trump’s leadership, the work to dismantle the swamp’s agenda isn’t finished—it’s just getting started.”

A breakdown released by Lankford’s office said the law will save the average family about $5,000 in additional taxes next year. There will be no tax on tips, an increased standard deduction for seniors to effectively eliminate taxation of Social Security benefits, no tax on overtime, and a tax break for those who buy new cars made in America.

Police officers, firefighters, truckers, linemen, and others who work overtime will take home an average of more than $1,300 a year because of no tax on overtime, Lankford’s office reported.

The law also provides families with a tax credit of $2,200 per child up to 16 years old every year.

In a release, Lankford said the long-run wage increase created by the new law in Oklahoma is projected to range from $4,800 to $9,100, according to the Council of Economic Advisers, and the take-home pay increase for a family of four is projected to range from $6,500 to $10,800.