Why I’m Against Work Requirements for Medicaid

Image Credit: smallbox on Unsplash.

If you haven’t heard, a bill recently passed in the U.S. House of Representatives that would, among other things, implement work requirements for some Medicaid recipients. If the bill passes in the U.S. Senate, able-bodied, adult Americans without dependents will be required to report 80 hours of work, education, or service each month to receive Medicaid. This change would go into effect on December 31, 2026, and it would almost certainly lead to millions of Americans losing their health coverage over the next decade.

Anyone who’s familiar with my work and my political leanings will not be surprised to learn I think healthcare is a human right that should be available to everyone, whether they’re employed or not. No one should have to go into medical debt to survive. No one should have to skip meals to pay for medication. The United States should tax the rich, reduce defense spending, and care for its people.

What might be news to those reading (or listening to) this, however, is why I’m against work requirements for Medicaid from a personal perspective.

Currently, I’m recuperating from working two jobs for most of the 2024/2025 school year. I worked nearly 60 hours each week while also commuting to another town, prioritizing family time, caring for pets, publishing my writing weekly on Liz’s Substack, and performing all of the essential duties, chores, and errands of keeping a home and maintaining a human body. Most nights, I considered myself lucky if I got five hours of sleep. Often, I only got four. It was really hard, and there’s no way in hell I could have done it if Medicaid hadn’t enabled me to get my debilitating chronic pain under control first.

I’ve suffered from migraines and severe menstrual and pre-menstrual pain since I was 12 years old. I’ve had cysts rupture on my ovaries. I’m no stranger to pain-induced nausea and vomiting. But like so many women who seek treatment, my pain was minimized by doctors. In fact, medical gaslighting made me feel like I couldn’t even call my condition chronic pain until my sister referred to it as such when I was in my late twenties. Around that same time, staying high and taking NSAIDs to dull my pain stopped being an option, so working full time stopped being an option. In my early thirties, part-time work and freelancing was the most I could manage, and even that was difficult.

By 2021, my chronic pain became so unmanageable that I had to postpone my start date for a part-time job. I sat at home, curled up with my heating pad, watching Twin Peaks and writhing in agony. I wanted to work; I was excited to start my new job. But all I could do was postpone and endure.

In 2022, I started taking a medication that worked wonders for my mental health and alleviated my pain somewhat; but it wasn’t until last summer — thanks to Medicaid and some wonderful doctors — that I finally found swift, significant, lasting pain relief. With two medications taken once daily, I’m able to effectively treat my chronic pain. I’m crossing my fingers this remains the case.

My health insurance is provided by my employer now, but if my access to Medicaid had depended on reporting 80 hours of work per month, I might still be living a life controlled by chronic pain. I wouldn’t be working a full-time job and a part-time job, I wouldn’t have paid off my student loans last winter, and I’d probably be living off of credit cards.

If politicians want more Americans working, increasing barriers to life-changing, life-saving healthcare isn’t the right move. And I think they might know this — how better to keep a population weak and compliant than to keep them desperate and hurting. You can’t sustain a second Gilded Age without a suffering working class, after all.

Other than calling and writing my representatives, I don’t know what to do about this big, horrible bill other than writing about how awful it is. I can only hope it doesn’t pass in the Senate. If it does pass, I can only hope my chronic pain stays manageable long enough for me to get ahead financially. With any luck, the meds will keep working, I’ll keep working, and the day will come when I can afford to help some of the Americans my government won’t.