[Congressional Record Volume 172, Number 97 (Tuesday, June 9, 2026)]
[Senate]
[Pages S2671-S2672]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]




                                MEDICAID

  Mr. GRASSLEY. Mr. President, 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 
percent, and a lot of people were saying having to go to work ended up 
being one of the best things in their life. It changed their life. So 
having a job gives people purpose and dignity. You guessed it; it is 
central to having a happy life.
  Now, more recently, along the lines of what we did in the 1990s, in 
the Working Families Tax Cut law, signed by the President last July 4, 
Congress established further commonsense work requirements for able-
bodied adults receiving Medicaid.
  Federal law already requires able-bodied adults to work if they are 
on food stamps and receiving Temporary Assistance for Needy Families 
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 January 1 of 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, any citizen in the United States--well, I mean, 
you don't even have to be a citizen. You just have to take advantage of 
giving your views on this interim rule. So let CMS know your view--that 
is 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 receive job training for at least 20 hours a 
week. So there are lots of flexibilities that ought to meet the needs 
of people who want to keep their Medicaid Advantage. In other words, if 
you are capable, you can't just sit at home watching television.
  Now, there have got to be some exceptions to this work requirement, 
so I will 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 is a reasonable 
thing to do. If people aren't able to work, and they still require 
Medicaid, they are exempt.
  There are other exemptions. If you are an able-bodied adult, but you 
are a caregiver or a parent with kids under 14 years of age, you are 
exempt from the work requirements.
  Also, if you have been hospitalized or need to get mental health 
treatment, you are exempted. There are other reasonable hardship 
exceptions for communities impacted by natural disaster or that have 
high unemployment rates.
  Now, if that sounds like there are so many exemptions that nobody 
will have to meet the 20-hour work requirement, there will be just 
many, many people that will have to work, go to school, or take care of 
volunteer work if you are going to get Medicaid, and it is a reasonable 
requirement.
  The Federal Government and many States are taking a data-first 
approach when implementing these work requirements: the government by 
using data and information to verify eligibility and exemptions before 
requiring the individual to prove they are compliant or exempted.
  The added benefit is this: For those people that have to work, go to 
school, work for a nonprofit, or have a real job, these work 
requirements can lead to improved health outcomes and a reduction of 
poverty.

[[Page S2672]]

  The interim final rule takes note of research that finds that 
``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 requirement will lift 1-6/10 to 2-9/
10 million people out of poverty, and that is exactly what we found as 
a result of the 1990 welfare reform bills that were passed by a 
Republican Congress when we had a Democrat President; in other words, 
very bipartisan.
  Commonsense Medicaid work requirements for able-bodied adults take 
the same approach as welfare reform did in the 1990s, and I am 
repeating that because it was an important move that had very positive 
outcome effects.
  So moving people from welfare to work and self-sufficiency was our 
goal in the 1990s, and it is a goal that was established in the tax 
bill of last year in regard to Medicaid.
  I yield the floor.
  I suggest the absence of a quorum.
  The PRESIDING OFFICER. The clerk will call the roll.
  The senior assistant bill clerk proceeded to call the roll.
  Mr. THUNE. Mr. President, I ask unanimous consent that the order for 
the quorum call be rescinded.
  The PRESIDING OFFICER. Without objection, it is so ordered.

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