Help us improve in just 2 minutes—share your thoughts in our reader survey.

Arguments about work requirements for public assistance programs

From Ballotpedia
Jump to: navigation, search
Work Requirements Banner Gold.png
Work requirements
Work Requirements Icon 200x200.png
• Index of articles
• Major arguments
• Reform proposals
•Medicaid work requirements
• Public housing work requirements
• SNAP work requirements
• Child care subsidy work requirements
• Laws
• Court cases
• Scholarly work

Work requirements for public assistance refer to conditions that require participation in employment-related activities to qualify for the assistance. These activities may include job searching, engaging in job training, volunteering, or working a specified number of hours each week.

Ballotpedia has tracked policies, legislation, arguments, and reform proposals for work requirements related to the following four public assistance programs:

This page features the main categories of arguments related to work requirements for public assistance programs:


  • Legal arguments about work requirements
    Read more
  • Operational arguments about work requirements
    Read more
  • Economic arguments about work requirements
    Read more
  • Arguments about the effects of work requirements on recipients
    Read more


Legal arguments about work requirements


Argument: Work requirements are lawful

This argument suggests that work requirements for public assistance programs are lawful under existing statutes and align with federalism principles.

  • Madeline Guth, a senior policy analyst with the Kaiser Family Foundation, wrote in a 2022 issue brief, "Adults who receive TANF cash assistance generally are required to participate in work, as one of the express purposes of TANF enumerated in statute is to 'end the dependence of needy parents on government benefits by promoting job preparation, work, and marriage.'"[1]
  • Plaintiffs in Bevin v. Stewart, a 2018 case challenging work requirements for Medicaid, argued that federalism grants states the flexibility to waive certain Medicaid requirements and experiment with different program approaches, such as work requirements, at the state level. The plaintiffs argued, "Under our system of federalism, the states have traditionally been viewed as laboratories of democracy, where innovative ideas can be tested on a smaller scale and, if successful, can be adopted more broadly. In recognition of that end, Section 1115 of the Social Security Act provides the Secretary of the Department of Health and Human Services (the 'HHS Secretary') with broad authority to waive Medicaid requirements. More specifically, the HHS Secretary can waive Medicaid requirements for a state '[i]n the case of any experimental, pilot, or demonstration project which, in the judgment of the Secretary, is likely to assist in promoting the objectives of . . . [Medicaid].' 42 U.S.C. § 1315(a)(1). Such a waiver is commonly referred to as a Section 1115 waiver."[2]

Argument: Work requirements are unlawful

This argument suggests that work requirements may violate the statutory goals of some public assistance programs and may deprive individuals of public assistance benefits in violation of constitutional due process protections.

  • The American Civil Liberties Union argued in a background briefing on its website, "Although the Constitution does not guarantee the right to receive welfare, the ACLU believes that reform of the public assistance system will likely implicate a variety of constitutional rights. In particular, once the government decides to give welfare benefits—as the United States did during the New Deal—there are constitutional limits to the conditions that it can attach to those benefits and to the treatment afforded beneficiaries."[3]
  • In Gresham v. Azar, a 2019 case challenging Medicaid work requirements, U.S. District Judge James Boasberg wrote, "The Court has said this before and will say it again: if, as Arkansas and HHS admit (and this Court has found), ensuring Medicaid coverage for the needy is a key objective of the Act, the Secretary’s failure to consider the effects of the project on coverage alone renders his decision arbitrary and capricious; it does not matter that HHS deemed the project to advance other objectives of the Act."[4]
  • Madeline Guth, a senior policy analyst with the Kaiser Family Foundation, wrote, "Congress has not identified work as an objective for the Medicaid program. The ACA aimed to make Medicaid available to low-income adults through its Medicaid expansion, regardless of whether a person also met categorical eligibility requirements such as being pregnant, a parent, senior, or person with a disability. After implementation of the ACA’s Medicaid expansion, the Obama Administration signaled it would not approve state waiver requests to require work as a condition of Medicaid eligibility, concluding in its denial of Arizona’s request that work requirements 'could undermine access to care and do not support the objectives of the [Medicaid] program.' In an effort to reframe Medicaid to a program akin to 'public assistance”, unsuccessful Republican attempts to repeal and replace the ACA in 2017 proposed allowing states to require work as a condition of Medicaid eligibility.'"[1]

Operational arguments about work requirements


Argument: Work requirements improve program efficiency

This argument suggests that work requirements can help reduce waste in federal public assistance programs by ensuring that resources are given to individuals in need of assistance rather than to able-bodied adults without dependents.

Claim: Work requirements reduce waste in public assistance programs by helping able-bodied individuals move out of poverty

This claim suggests that work requirements help able-bodied adults without dependents move out of poverty by supplementing public benefits with earnings.

  • Akash Chougule and Nathan Nascimento, policy analysts with Americans for Prosperity, wrote in a 2018 policy memo, "Federal and state research shows that work requirements are one of the most effective ways to lift people out of poverty and reduce government dependence, while also ensuring the safety net exists for those who truly need it. ... From 1995 to 2013, the number of welfare recipients in New York City shrank from almost 1.1 million to less than 347,000 — a drop of more than 700,000 men, women and children. On top of that, employment rates for single mothers increased from 43 percent in 1994 to 63 percent in 2009. New York City also saw a steep decline in the number of children living under poverty – from 42 percent in 1994 to 28.3 percent in 2008."[5]

Claim: Work requirements make public assistance programs more sustainable

This claim suggests that work requirements reduce the cost of public assistance programs and make them more sustainable by moving able-bodied adults without dependents out of poverty.

  • Former White House advisor on welfare issues and Brookings Institution analyst Ron Haskins in his 2007 book Work over Welfare argued, "If the 1996 reforms had their intended effect of reducing welfare dependency, a leading indicator of success would be a declining welfare caseload. TANF administrative data reported by states to the federal government show that caseloads began declining in the spring of 1994 and declined more rapidly after the federal legislation was enacted. Between 1994 and 2004, the caseload declined about 60 percent. The number of families receiving cash welfare is now the lowest it has been since 1969, and the percentage of children on welfare is lower than it has been since 1966. Although it is often reported in the media that cash welfare caseloads increase during economic recessions and decline during recoveries, this claim is mostly false. In the forty-one years between 1953 and 1994, the number of families on AFDC declined to only five. Only once–between 1977 and 1979–did the caseload decline (by about 2 percent) two years in a row. By contrast, 2005 was the eleventh year in a row that the caseload declined. Clearly, we are in a new era of welfare use."[6]
  • A survey conducted by the physician recruiting firm Merritt Hawkins found that a "large majority of physicians support adding work requirements as a condition for Medicaid coverage ... The single-question survey found that 56.6 percent of doctors feel very favorably about work requirements, while 17.8 percent feel somewhat favorably about them. In contrast, 9.2 percent reported feeling very unfavorably, and 8.4 percent said they feel somewhat unfavorably." Merrit Hawkins "said the results may indicate general frustration with Medicaid and a desire by doctors for any change to the status quo" of the Medicaid fee structure, which can result in doctors paying more to provide care to Medicaid patients than they receive in reimbursement, according to 2018 article in Inside CMS.[7]

Argument: Work requirements increase administrative burdens

This argument suggests that work requirements cause state agencies and program recipients to increase the amount of time and resources needed to follow reporting requirements.

Claim: Work requirements increase state administrative costs

This claim suggests that work requirements result in increased state administrative costs in order to develop administrative systems and staff agencies tasked with overseeing work requirements in public assistance programs.

  • Professors Rachel Garfield, Robin Rudowitz and MaryBeth Musumeci, wrote in a 2019 issue brief for the Kentucky Medicaid Tracker, "New requirements will increase administrative costs, complexity and potential coverage losses among those who remain eligible. States implementing work requirements will likely have to design new systems to reflect changes in eligibility rules, to enable enrollees to report compliance, to interface with other programs (such as SNAP, TANF, or employment training), to implement coverage lock-out periods, and to exchange eligibility information among the state, enrollment broker, health plans, and providers."[8]
  • Liz Schott and Ladonna Pavetti, CBPP policy analysts, wrote in a 2013 report, "monitoring TANF recipients’ work participation is burdensome and costly for states. States are required to track and document every hour of every recipient’s participation. This means that states devote significant staff time to tracking hours rather than providing direct service to individuals that could improve their prospects for securing employment or make them more job-ready."[9]

Claim: The SNAP program formula already incentivizes work activity

This claim suggests that work requirements are unnecessary for SNAP because the SNAP program formula is calculated in a way that incentivizes work without a specific mandate.

  • Dorothy Rosenbaum, CBPP senior fellow, wrote in a 2013 report, "The SNAP benefit formula includes work incentives. SNAP targets benefits based on a household’s income and expenses, including a deduction for earned income to reflect the cost of work-related expenses and to function as a work incentive. As a result of the SNAP benefit calculation rules, SNAP households are financially better off if they are able to secure employment or increase their earnings."[10]

Claim: Work requirements may cause people to lose coverage due to administrative requirements

This claim suggests that public assistance recipients can lose coverage because work requirements reporting structures are unclear.

  • Hahn wrote, "Work requirements do or could create burdensome administrative procedures affecting many people who are eligible for TANF, SNAP, and Medicaid as well as the agencies administering the programs. Studies of Medicaid and SNAP have shown that even without work requirements, eligible people lose access to basic health care and food for administrative reasons such as not completing paperwork on time, not receiving notices, or office errors."[11]
  • Andis Robeznieks, a senior communications specialist for American Medical Association, wrote, “The effect of Medicaid work requirements, it was said [by the American Medical Association], would be to increase administrative costs and burdens on states as well as documentation burdens on a vulnerable population. Delegates raised concerns that imposing Medicaid work requirements would cause some people now covered by Medicaid to lose their health insurance.”[12]
  • Aviva Aron-Dine, former CBPP analyst, wrote in a 2018 report, "Tens of thousands of enrollees will lose Medicaid because they don’t meet new eligibility or paperwork requirements; there is no reason to expect that many of those enrollees will be able to replace Medicaid with other coverage."[13]
  • Hahn wrote, "Work requirements do or could create burdensome administrative procedures affecting many people who are eligible for TANF, SNAP, and Medicaid as well as the agencies administering the programs. Studies of Medicaid and SNAP have shown that even without work requirements, eligible people lose access to basic health care and food for administrative reasons such as not completing paperwork on time, not receiving notices, or office errors."[11]
  • Garfield, Rudowitz, and Musumeci wrote, "Specifically, under all scenarios, most disenrollment would be among individuals who would remain eligible but lose coverage due to new administrative burdens or red tape versus those who would lose eligibility due to not meeting new work requirements."[14]
  • Katch, Wagner, and Aron-Dine wrote, "State proposals for Medicaid work requirements will cause many low-income adults to lose health coverage, including people who are working or are unable to work due to mental illness, opioid or other substance use disorders, or serious chronic physical conditions, but who cannot overcome various bureaucratic hurdles to document that they either meet work requirements or qualify for an exemption from them."[15]
  • Jennifer Wagner and Jessica Schubel, CBPP policy analysts, wrote in a 2019 policy paper, "Neither state hired additional staff to answer questions, and, at least in Arkansas, there were no accommodations for individuals with disabilities. Arkansas Human Services Director Cindy Gillespie justified the lack of additional staff by saying, 'If you implement [work requirements] in the old-fashioned way of ‘Come into our county office,’ we would have to hire so many people — and that just doesn’t make sense.' But Arkansas’ failure to invest in staff and other resources to support enrollees who should be exempt or need help complying with the requirements created a bureaucratic maze that caused many eligible enrollees to lose coverage."[16]

Economic arguments about work requirements


Argument: Work requirements strengthen the economy

This argument suggests that work requirements will positively affect the economy by incentivizing participation in the workforce.

Claim: Work requirements incentivize able-bodied adults and parents to enter the workforce

This claim suggests that public assistance programs disincentivize able-bodied adults and parents from entering the workforce. Work requirements, according to this claim, can encourage people to enter the workforce to supplement benefits with earnings or move off of public assistance.

  • Falk, McCarty, and Aussenberg wrote, "Work requirements counteract the work disincentives of government benefits by requiring a recipient to engage in a labor market-related activity—rather than nonmarket activity, such as homemaking, child-rearing or leisure—as a condition of receiving government benefits. That is, they create a mandated activity, which may potentially be non-paid (e.g., job search), that affects the decision of individuals to work or accept a job offer. Failure to engage in that mandated activity can result in a reduction or end of the government benefit."[17]
  • Rachel Sheffield, a former policy analyst at the Heritage Foundation, argued in a 2016 commentary piece, "Work requirements serve as a gatekeeper to ensure that those truly in need receive welfare assistance. Benefits are available to those who need them, but individuals who could otherwise find a job are directed toward work. This policy benefits not only taxpayers but also the individuals who are steered toward the job market, where they can build their resumes, skills and connections."[18]
  • Haskins wrote, "modern social science has produced strong and consistent evidence that public welfare does reduce work. A thorough 1981 review of these studies by the prominent social scientists Sheldon Danziger, Robert Haveman, and Robert Plotnick confirms that AFDC reduced the hours of work by single mothers."[6]
  • Haskins further wrote, "Census evidence shows historic changes in employment (defined as any earnings during the year) by single mothers, especially low-income single mothers. From 1993 to 2000 the portion of single mothers who were employed grew from 58 percent to nearly 75 percent, an increase of almost 30 percent."[6]

Claim: Work requirements can help strengthen the labor force after the coronavirus (Covid-19) pandemic

This claim suggests that the coronavirus (Covid-19) pandemic led employers to furlough workers, which resulted in a worker shortage. Work requirements, according to this claim, can incentivize able-bodied adults without dependents to rejoin the workforce and help mitigate the post-pandemic labor shortage.

  • FGA policy analysts Alli Fick and Scott Centorino argued in a 2021 white paper, "More than 10 million jobs are currently open across America, from food services and hospitality to manufacturing, education, and financial services. Businesses are looking for workers and policymakers are looking for solutions. Federal unemployment and welfare benefits have played an outsized role in driving the current worker shortage. ... Work requirements in food stamps rank among the most effective tools in lifting individuals out of dependency into self-sufficiency. Studies across multiple states have demonstrated how able-bodied adults leaving food stamps after work requirements are implemented find work in thousands of diverse industries and see their incomes more than triple"[19]

Argument: Work requirements weaken the economic impact of public assistance

This argument suggests that public benefits stimulate the economy. Work requirements, according to this argument, hurt the economy by creating barriers to entry that reduce enrollment numbers.

Claim: Work requirements cannot solve the social problem of poverty

This claim suggests that work requirements cannot solve poverty as a social problem because circumstances beyond unemployment contribute to poverty.

  • Lisa D. Brush, sociology professor at the University of Pittsburgh, wrote in a 2003 journal article, "Ken Neubeck and Noel Cazenave point out that racism in welfare reform has many consequences. It masks the structural causes of poverty and welfare recipiency, and hides the racially differentiated barriers to welfare-to-work transition. By blaming individual failings or ‘cultural pathology’ for poverty and inequality, welfare racism deflects criticism and frustrates activism."[20]

Claim: Work requirements reduce the positive economic impact of SNAP benefits

This claim suggests that SNAP benefits increase the purchasing power of program recipients and that, by reducing the number of enrollees in the SNAP program, work requirements reduce the economic stimulus of SNAP benefits.

  • Lauren Bauer, Jana Parsons, and Jay Shambaugh, policy analysts at The Hamilton Project, wrote in a 2020 analysis, "During difficult economic times SNAP alleviates hardship and stimulates the economy by subsidizing food consumption; at the depths of the Great Recession, SNAP provided resources to purchase food for one out of every six Americans (Hoynes and Schanzenbach 2019). While we do not yet know how the COVID-19 pandemic will shape the economy in the coming weeks, months, and years, a nationwide SNAP work requirement suspension can only help the country and its most vulnerable households to weather this crisis."[21]

Arguments about the effects of work requirements on recipients




Argument: Work requirements encourage self-sufficiency

This argument suggests the work requirements incentivize people to become self-sufficient, reducing the amount of people reliant on public assistance and the number of people living in poverty.

Claim: Work requirements can disincentivize behaviors that lead to dependency

This argument suggests that public assistance programs reduce work incentives, which causes recipients to rely on public assistance programs as their primary source of income. Work requirements, according to this claim, can disincentivize such behavior.

  • Kristina Rasmussen, vice president at FGA, wrote in USA Today, "Reinstating work as the bedrock of the welfare system is imperative if we are to reprioritize the truly needy, continue to boost the economy and reduce the dependency crisis in America. Having a job is the single-best indicator of whether someone will fall into dependency. Research has shown time and time again that work requirements for able-bodied adults are the most effective way to quickly move adults from welfare to work and ensure that the safety net is preserved for the truly needy."[22]

Claim: Work requirements promote self-sufficiency

This claim suggests that public assistance programs incentivize people to rely on governmental programs and that work requirements can incentivize able-bodied adults without dependents to join the labor market and earn a liveable wage.

  • Vicki A. Lens, professor at Columbia University, wrote in a 2008 journal article, "By requiring recipients to engage in work activities, under threat of financial penalties if they do not, self-sufficiency is encouraged rather than dependency. Although welfare reform legitimizes hassle by requiring sanctions, the welfare system has also been reconfigured to help recipients to become self-sufficient."[23]
  • A 2021 FGA policy paper argued, "Every job has dignity and value in promoting self-sufficiency and building communities, but adults who leave welfare after work requirements actually find work in hundreds of different industries. Research shows that many individuals who found immediate work at temp agencies or in lower-wage industries were able to successfully transition into higher-paying, longer-term employment within just a few months."[24]

Argument: Work requirements do not lead to self-sufficiency

This argument suggests that work requirements do not effectively help people climb out of poverty because often recipients are already working or do not have the opportunity to do so.

Claim: The work opportunities available to public assistance recipients do not reduce poverty or lead to self-sufficiency

This claim suggests that work requirements do not alleviate poverty because the employment opportunities available to public assistance recipients, due in part to educational barriers, do not provide the wages or consistency needed to achieve self-sufficiency.

  • Aviva Aron-Dine, Raheem Chaudhry, and Matt Broaddus, policy analysts at the Center on Budget and Policy Priorities (CBPP), wrote in a 2018 policy paper, "But while most adults in low-income families worked substantially, many did not work continuously and for a consistent number of hours each month. As a result, 46 percent of likely Medicaid-eligible low-income working adults would have been at risk of losing their Medicaid coverage for at least one month during the year under Kentucky’s work requirement."[25]
  • Heather Hahn, vice president at the Urban Institute, wrote, "Work requirements don’t necessarily help people find jobs, and certainly not jobs that lift people out of poverty."[11]
  • Hahn further wrote, "Although most families worked at some point both while they received TANF and after they left, their employment was unsteady and did not lift them out of poverty. Families who left TANF because of time limits or work sanctions had the worst outcomes: four years after leaving, 70 percent had incomes below half the poverty level (if they had earnings at all). Median annual earnings were just $2,175 for families who left TANF because of work sanctions. Thus, the work requirement contributed to their leaving TANF but did not help them achieve self-sufficiency."[11]
  • Sandra K. Danziger, professor of social work at the University of Michigan, wrote in a 2010 journal article, "Liberals, such as Wilson, argued in contrast that nonwork was involuntary. The disappearance of manufacturing jobs from central cities and the increasing demand by firms for educational credentials and skills meant that many inner-city residents could not get or keep jobs. Liberals also pointed out that even if welfare recipients could find jobs, they would only find low-wage jobs."[26]
  • Gayle Hamilton, a researcher for the U.S. Department of Health and Human Services' (HHS) National Evaluation of Welfare-to-Work Strategies, wrote in a 2002 program analysis, "One of the most important points to take away from this summary is that, although welfare recipients are a diverse group, a sizeable proportion of them face one or more barriers to steady employment. Among these barriers are a lack of a high school diploma or GED, no recent employment, a long history of welfare receipt, health or emotional problems, a high risk of depression, and a reluctance to leave one's children to go to work. At study entry, about two-fifths of the sample members lacked a high school diploma or GED, having completed an average of slightly less than 10 years of school. These sample members are often referred to here as nongraduates; sample members who had at least one of these credentials are referred to as graduates. A sizeable proportion of people in the sample lacked a work history, had been on welfare for at least five years cumulatively, or both. Slightly more than one-quarter of the sample members reported at study entry that they or a family member had a health or emotional problem. About one-seventh were found to be at high risk of depression. Finally, one-quarter of sample members reported strongly preferring staying home with their children over going to work."[27]

Claim: Medicaid work requirements are unnecessary because most enrollees already meet work requirements

This claim suggests that public assistance recipients are already working to supplement public assistance benefits and that work requirements will not help them rise out of poverty.

  • Benjamin D. Sommers, Carrie E. Fry, Robert J. Blendon and Arnold M. Epstein, professors writing for Health Affairs in 2018, argued, "Our study showed that most potential Medicaid beneficiaries are either already working or disabled. We add a new finding to this literature: Only 11 percent of potential Medicaid beneficiaries reported that a work requirement would have any effect on their looking for a job, though this did represent more than half of the 17 percent who were not working and were not disabled. Notably, this potential effect was disproportionately reported by rural adults—which raises questions as to the availability of employment for people who would look for work if required, given the paucity of new jobs in rural areas over the past decade."[28]

Claim: Work requirements do not capture all work activities

This claim suggests that the work activities that satisfy work requirements do not capture other forms of work performed by public assistance recipients, such as work activity unverified by an employer.

  • Lens wrote that "caseworkers refused to accept clients’ statements as employment verification when they worked off the books. Other forms of proof are also rejected because they do not fit the bureaucratic mold. For example, fair hearing data include the story of a client whose employer, a restaurant owner, refused to verify her employment. She unsuccessfully tried to reverse her sanction by providing the hearing officer with letters from two people who saw her working and with case notes from the files of a local legal services attorney, who confirmed that the employer would not verify employment."[23]

Argument: Work requirements improve recipient well-being

This argument suggests that work requirements can incentivize public assistance recipients to adopt good behaviors or habits that positively influence their lives.

Claim: Work requirements will ensure that assistance goes to the truly needy (sometimes referred to as the 'screening argument')

This claim suggests that requiring able-bodied adults without dependents to meet work requirements in order to receive public assistance benefits will help ensure that public benefits are directed to the individuals most in need of assistance.

  • Gene Falk, Maggie McCarty, and Randy Alison Aussenberg, policy analysts writing for the Congressional Research Service (CRS), wrote in a 2014 CRS report, "Time limit and work requirement or incentive policies that move families out of federal assistance can free up federal resources for other priorities. The requirement to be engaged in an activity imposes a 'time cost' on benefit receipt, and for some individuals, the value of the benefit may not exceed the cost of having to engage in a work or job preparation activity. It has been argued that work requirements 'screen' out those not in true need of benefits, limiting benefits to those who have little alternative."[29]
  • Hayden Dublois and Jonathan Ingram, policy analysts at the Foundation for Government Accountability (FGA), wrote in Real Clear Health, "What happens when you take a program intended for the truly needy, and place millions of able-bodied, working-age adults on it in an instant? We don’t have to speculate to find an answer—because in 2014, that’s exactly what happened when ObamaCare’s Medicaid expansion was implemented. As a result, budgets were busted and providers struggled, all while the most vulnerable have had to continue to wait for their care."[30]

Claim: Medicaid work requirements promote better health for recipients

This claim suggests that work requirements positively affect public assistance recipients' health by creating a routine wherein recipients are required to work or participate in work-related activities.

  • The Centers for Medicare and Medicaid Services (CMS) in a 2018 letter to state Medicaid directors argued in favor of work requirements as a means to improve health outcomes: "CMS recognizes that a broad range of social, economic, and behavioral factors can have a major impact on an individual’s health and wellness, and a growing body of evidence suggests that targeting certain health determinants, including productive work and community engagement, may improve health outcomes. For example, higher earnings are positively correlated with longer lifespan. One comprehensive review of existing studies found strong evidence that unemployment is generally harmful to health, including higher mortality; poorer general health; poorer mental health; and higher medical consultation and hospital admission rates. Another academic analysis found strong evidence for a protective effect of employment on depression and general mental health. A 2013 Gallup poll found that unemployed Americans are more than twice as likely as those with full-time jobs to say they currently have or are being treated for depression. Other community engagement activities such as volunteering are also associated with improved health outcomes, and it can lead to paid employment."[31]

Claim: Work requirements promote better outcomes for parents and children

This claim suggests that work requirements enable parents to model good behavior for their children, which can help children earn better grades in school and break the generational cycle of welfare dependency.

  • In a policy paper discussing food stamp work requirements, FGA argued, "Work is the best way to reduce dependency for all able-bodied adults, both those without kids and parents. Work requirements can help parents model good behavior for children, ending the cycle of dependency for children."[32]
  • Haskins wrote, "Five results are notable: positive impacts on school achievement were evident among children whose mothers were in certain work programs; impacts were confined to children age five and under at the beginning of the studies; impacts were confined to work programs that increased the family income by providing earnings supplements; impacts faded after three years; and positive impacts on school achievement were related to attendance at center-based child care programs during the preschool years. These results are broadly consistent with the large literature on effects of maternal employment, including the finding that when mothers’ work leads to increased family income, young children often show modest improvement on measures of social and intellectual development."[6]

Argument: Work requirements harm recipient well-being

This argument suggests that work requirements do not have a positive impact on recipients' lives and harm individuals in different ways.

Claim: Work requirements make it more difficult for the truly needy to get help through public assistance

This claim suggests that work requirements will make it difficult for those who need public assistance to qualify for public assistance programs.

  • CBPP policy analysts Hannah Katch, Jennifer Wagner, and Aviva Aron-Dine wrote in a 2018 policy paper, "Work requirements will make it harder for most adult beneficiaries—the lion’s share of whom are already working or are ill, disabled, caregivers, or in school—to get and stay covered."[33]
  • Robert Moffitt, professor of economics at Johns Hopkins University, wrote in a 2001 Brookings Institution policy brief, "The flip side of the high employment rates of 60 to 75 percent of women who have left welfare is that 25 to 40 percent of those women are not working. Indeed, some studies have indicated that as many as 18 percent of leavers in some areas have not worked at all for a full year after leaving the rolls. This group is of some concern. Because they have lost their welfare benefits and do not have earnings, they have lower incomes than nonworking women who are still on TANF. Some fraction of these nonworking leavers have a spouse or partner who brings in some income to the household, and others supplement their income with benefits from other government programs. One of the most common program benefits received by this group are disability benefits from either the Supplemental Security Income program or the Social Security Disability Insurance program for the mother or her children, a reflection of a high prevalence of health problems and disability that hinders work. Nevertheless, even with the income from other family members and from government programs, nonworking leavers have considerably lower income than they did when they were on welfare and, consequently, leaving welfare has been particularly disadvantageous for these women and their children."[34]

Claim: Work requirements reduce health and employment outcomes

This claim suggests that work requirements can result in public assistance recipients no longer qualifying for Medicaid, SNAP, or other benefits, which can reduce health outcomes and negatively affect labor force participation.

  • Drew Altman wrote in an article titled "Making Sense of Medicaid Work Requirements" that the implementation of these conditions would result in 600,000 more uninsured Americans and that there would be no impact on workforce participation. He further argues that most Medicaid recipients are already working or exempt and that those who are working are typically working jobs that do not offer healthcare coverage.[35]
  • Benjamin D. Sommers, Lucy Chen, Robert J. Blendon, E. John Orav, and Arnold M. Epstein wrote in their paper titled "Medicaid Work Requirements In Arkansas: Two-Year Impacts On Coverage, Employment, And Affordability Of Care" that "people in Arkansas ages 30-49 who had lost Medicaid in the prior year experienced adverse consequences: 50 percent reported serious problems paying off medical debt, 56 percent delayed care because of cost, and 64 percent delayed taking medications because of cost."[36]
  • Hahn wrote, "Access to affordable health care helps people maintain their health so they can look for and keep jobs. Illness or disability is the single most common reason that working-age adults living in poverty are not working (Rachidi 2016). According to a recent comprehensive report from the Ohio Department of Medicaid, more than half of people who enrolled after the state expanded eligibility reported that Medicaid made it easier to secure and maintain employment"[11]
  • Professors Lindsay Allen, Diana Henry, and Alicia Atwood, wrote in a 2023 article for Health Services Research, "Food insecurity—a lack of consistent access to food for all household members—is associated with poor mental health outcomes, including higher rates of depression and anxiety. Beyond the biological link between inadequate nutrition and mental health, feelings of alienation, worry, guilt, irritability, and shame from being food insecure also have a negative psychological impact. Women are especially vulnerable to these adverse effects because they are over-represented among low-income groups and are often responsible for household caretaking and food preparation."[37]
  • The American Medical Association (AMA) in 2021 passed a resolution opposing work requirements as a condition for certain public assistance programs. In a press release announcing the policy, the AMA argued, "Delegates voted to oppose work requirements for the Supplemental Nutrition Assistance Program (SNAP) and the Temporary Assistance for Needy Families. AMA policy already opposes work requirements for Medicaid as those requirements have not proved to boost health outcomes or reduce employment barriers."[38]
  • Professors Benajmin Sommers and Heidi Allen wrote in a 2020 article for The JAMA Forum, "Despite its general support for work requirements, CMS had rejected a proposal from Mississippi in 2018, arguing that the lack of Medicaid expansion in the state rendered work requirements problematic due to a phenomenon called a 'subsidy cliff.' If a beneficiary obtains a new job to meet the requirements in most nonexpansion states, the additional income may leave the person ineligible for Medicaid but still too poor to qualify for the ACA’s subsidized private coverage. CMS concluded that this makes little sense because the policy would require people to work to keep their insurance coverage but would then take away that coverage once they got a job."[39]

Claim: Work requirements disproportionately harm women and Black families

This claim suggests that work requirements have disproportionately negative effects on women and Black families that keep them from moving out of low-wage jobs.

  • Vanessa D. Johnson, associate professor of applied psychology at Northeastern University, wrote in a 2010 journal article, "African American women may not have been the majority of recipients of welfare prior to welfare reform, but they seem to be the greatest recipients of the punitive nature of the new reform policies. One such policy, as related to welfare reform, is the Work First policy, which requires women to work in order to receive benefits. This policy is considered punitive in that it condemns single mothers to minimum wage employment with no access to the career advancements that postsecondary education might bring."[40]

Claim: Work requirements negatively affect adolescent children of public assistance recipients

This claim suggests that work requirements take parents away from their family responsibilities, which negatively affects adolescent children.

  • Researchers Lisa Gennetian, Greg Duncan, Virginia Knox, Wanda Vargas, Elizabeth Clark-Kuffman, and Andrew London wrote in a 2002 analysis of work and public assistance policies, "When asked about their adolescent children, parents in the programs under study reported worse school performance, a higher rate of grade repetition, and more use of special educational services than did control group parents. On average, the programs did not, however, affect the proportion of adolescents who dropped out of, were suspended from, or completed school. There were likewise no overall differences between the program and control groups in the proportion of adolescents who had children. Girls and boys fared similarly on all the outcomes examined."[41]

See also


External links

Footnotes

  1. ↑ 1.0 1.1 Kaiser Family Foundation, An Overview of Medicaid Work Requirements: What Happened Under the Trump and Biden Administrations? accessed March 20, 2023
  2. ↑ JUSTIA, Bevin v. Stewart, accessed March 20, 2023
  3. ↑ ACLU, BACKGROUND BRIEFING: THE CIVIL LIBERTIES ISSUES OF WELFARE REFORM, accessed February 28, 2023
  4. ↑ Casetext, Gresham v. Azar, accessed March 15, 2023
  5. ↑ Americans for Prosperity, Work requirements help lift people out of poverty, accessed March 9, 2023
  6. ↑ 6.0 6.1 6.2 6.3 Brookings, Work over Welfare, accessed March 9, 2023
  7. ↑ Inside CMS, Survey, accessed February 24, 2023
  8. ↑ KY Medicaid Tracker, Implications of a Medicaid Work Requirement: National Estimates of Potential Coverage Losses, accessed February 24, 2023
  9. ↑ CBPP, Family Income Support changes in TANF work requirements could make them more effective, accessed March 9, 2023
  10. ↑ Center on Budget and Policy Priorities, The Relationship Between SNAP and Work Among Low-Income Households, accessed February 24, 2023
  11. ↑ 11.0 11.1 11.2 11.3 11.4 Urban Institute, Work Requirements in Safety Net Programs Lessons for Medicaid from TANF and SNAP, accessed February 24, 2023
  12. ↑ American Medical Association, Physicians oppose harmful changes to Medicaid benefits rules, accessed March 15, 2023
  13. ↑ Center on Budget and Policy Priorities, Eligibility Restrictions in Recent Medicaid Waivers Would Cause Many Thousands of People to Become Uninsured, accessed February 24, 2023
  14. ↑ KY Med Tracker, Implications of a Medicaid Work Requirement: National Estimates of Potential Coverage Losses, accessed February 28, 2023
  15. ↑ Center on Budget and Policy Priorities Taking Medicaid Coverage Away From People Not Meeting Work Requirements Will Reduce Low-Income Families’ Access to Care and Worsen Health Outcomes, accessed February 24, 2023
  16. ↑ Center on Budget and Policy Priorities, States’ Experiences Confirming Harmful Effects of Medicaid Work Requirements, accessed February 24, 2023
  17. ↑ Congressional Research Service, Work Requirements, Time Limits, and Work Incentives in TANF, SNAP, and Housing Assistance, accessed February 22, 2023
  18. ↑ Heritage Foundation, Welfare reform must include work requirements, accessed March 9, 2023
  19. ↑ The Foundation for Government Accountability, One tool to unleash economic recovery and solve the labor crisis, accessed February 23, 2023
  20. ↑ Race, Gender, and Class, Impacts of Welfare Reform, accessed February 24, 2023
  21. ↑ Hamilton Project, Who Stands to Lose If the Final SNAP Work Requirement Rule Takes Effect? accessed February 24, 2023
  22. ↑ USA Today, Welfare reform immensely popular, accessed March 9, 2023
  23. ↑ 23.0 23.1 Columbia University, Welfare and Work Sanctions: Examining Discretion on the Front Lines, accessed February 24, 2023
  24. ↑ The Foundation for Government Accountability, Eliminating waivers from work requirements in food stamps, accessed February 23, 2023
  25. ↑ Center on Budget and Policy Priorities, Many Working People Could Lose Health Coverage Due to Medicaid Work Requirements, accessed February 24, 2023
  26. ↑ Annual Review of Sociology, The Decline of Cash Welfare and Implications for Social Policy and Poverty, accessed February 24, 2023
  27. ↑ ERIC, Moving People from Welfare to Work: Lessons from the National Evaluation of Welfare-to-Work Strategies, accessed February 24, 2023
  28. ↑ Health Affairs, New Approaches In Medicaid: Work Requirements, Health Savings Accounts, And Health Care Access, accessed February 24, 2023
  29. ↑ Congressional Research Service, Work Requirements, Time Limits, and Work Incentives in TANF, SNAP, and Housing Assistance, accessed February 22, 2023
  30. ↑ Real Clear Health, Setting the Record Straight on Medicaid Work Requirements, accessed February 21, 2023
  31. ↑ Centers for Medicare and Medicaid Services, Letter to state Medicaid directors, January 11, 2018
  32. ↑ The Foundation for Government Accountability, Discussing Food Stamp Work Requirements, accessed March 3, 2023
  33. ↑ Center on Budget and Policy Priorities, Taking Medicaid Coverage Away From People Not Meeting Work Requirements Will Reduce Low-Income Families’ Access to Care and Worsen Health Outcomes, accessed February 24, 2023
  34. ↑ Johns Hopkins University, From Welfare to Work: What the Evidence Shows, accessed February 24, 2023
  35. ↑ KFF.org, "Making Sense of Medicaid Work Requirements," accessed August 21, 2025
  36. ↑ Health Affairs, Medicaid Work Requirements In Arkansas: Two-Year Impacts On Coverage, Employment, And Affordability Of Care, accessed February 24, 2023
  37. ↑ Health Services Research, SNAP work requirements increase mental health care use, accessed March 3, 2023
  38. ↑ American Medical Association, AMA announced policies adopted on final day of Special Meeting, June 16, 2021
  39. ↑ JAMA Network, Medicaid Work Requirements Shift to New Terrain, accessed March 3, 2023
  40. ↑ Northeastern University, Impact of Race and Welfare Reform on African American Single Mothers' Access to Higher Education, accessed February 24, 2023
  41. ↑ ERIC, How Welfare and Work Policies for Parents Affect Adolescents: A Synthesis of Research, accessed February 24, 2023
Retrieved from "https://ballotpedia.org/wiki/index.php?title=Arguments_about_work_requirements_for_public_assistance_programs&oldid=10483525"