Floor Remarks by Senator Chuck Grassley of Iowa
Senate President Pro Tempore
“Implementing Commonsense Medicaid Work Requirements”
Tuesday, June 9, 2026
During the mid to late 1990s, President Clinton and a Republican Congress worked hard to do a bipartisan reform package.
It required work requirements for people who were on welfare. It was a great success.
It reduced [the] welfare population by about 40%, and a lot of people were saying having to go to work ended up being one of the best things in their life [and] changed their life.
So, having a job gives people purpose and dignity. You guessed it, it’s central to having a happy life.
Now more recently, along the lines of what we did in the 1990s, in the Working Families Tax Cuts Law, signed by the president last July 4th, Congress established further commonsense work requirements for able-bodied adults receiving Medicaid.
Federal law already requires able-bodied adults to work if they’re on food stamps and receiving Temporary Assistance for Needy Families (TANF) cash assistance.
As required in last year’s tax bill, last week, following up on that statutory requirement, the Centers for Medicare and Medicaid Services — CMS for short — released regulations for these work requirements before their implementation [on] January 1st, next year.
Now the public has a chance to comment on the interim final rule through the end of July.
So, before the end of July, [anyone] in the United States [can] ... let CMS know [their] view. That’s everybody and anybody.
As the law requires, the Medicaid work requirements only apply to able-bodied adults, ages 19 to 64. To fulfill the requirements, a person has a lot of alternatives: getting a job for at least 20 hours a week, going to school at least 20 hours a week or volunteering at least 20 hours a week or receiving job trainings for at least 20 hours a week.
So, there’s lots of flexibilities that ought to meet the needs of people who want to keep their Medicaid. In other words, if you’re capable, you can’t just sit at home watching television.
Now, there’ve got to be some exceptions to this work requirement. So, I’ll discuss those at this point.
The elderly, people with disabilities, medically frail, pregnant women and children are all exempt from the work requirements.
That makes sense; it’s a reasonable thing to do. If people aren’t able to work [and] they [still need] Medicaid, they are exempted.
There’s other exemptions. If you’re an able-bodied adult, but you’re a caregiver or parent with kids under 14 years of age, you’re exempt from the work requirements.
Also, if you’ve been hospitalized or need to get mental health treatment, you’re exempted.
There are other reasonable hardship exemptions for communities impacted by natural disaster[s] or that have high unemployment rates...
The federal government and many states are taking a data-first approach when implementing these work requirements. The government [does this] by using data and information to verify eligibility and exemptions before requiring the individual to prove they’re compliant or exempted.
The added benefit is this: for those people that have to work, go to school or work for a non-profit or have a real job, these work requirements can lead to improved health outcomes and a reduction of poverty.
The interim final [rule] takes note of research that finds: “obtaining and maintaining stable employment is associated with improved physical and mental health outcomes and greater overall well-being, while unemployment and unstable work are linked to poorer health outcomes.”
In other words, working is good for your health.
New evidence also shows the work requirements will lift 1.6 to 2.9 million people out of poverty.
And that’s exactly what we found as a result of the 1990[s] welfare reform bills that were passed by a Republican Congress when we had a Democrat president. In other words, very bipartisan [bills].
Commonsense Medicaid work requirements for able-bodied adults take the same approach as welfare reform did in the 1990s, and I’m repeating that because it was an important move that had very positive effects.
So, moving people from welfare to work and self-sufficiency was our goal in the 1990s, and it was a goal that was established in the tax bill last year in regard to Medicaid.
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