Russell T. Vought, President Trump’s nominee to run the Office of Management and Budget, told Senate lawmakers in a confirmation hearing on Wednesday that he supported work requirements for low-income Americans receiving publicly subsidized health insurance, a policy that Mr. Trump pursued in his first term but that the Biden administration mostly reversed.
The comments suggested that the Trump administration was likely to seek a broad overhaul of how the federal government administers Medicaid, the joint federal-state health insurance program for more than 70 million people. They also signaled that work requirements were likely to become a focal point in Mr. Trump’s approach to the American safety net.
Mr. Vought cited as a model the welfare reform bill signed into law in 1996, which required low-income Americans to prove they were working before receiving safety net benefits.
“It’s informed not only Medicaid, but other programs, to be able to encourage people to get back into the work force, increase labor force participation and give people again the dignity of work,” he told members of the Senate Budget Committee.
Democrats have been sharply critical of adding work requirements to Medicaid, saying that they require complex enrollment procedures that make it hard to secure and maintain coverage, shutting out people with no other options for health insurance. Most Medicaid recipients are already working, while many of those who don’t are taking care of family or managing debilitating health conditions.
Estimates from the Congressional Budget Office say Medicaid work requirements would cause roughly 600,000 people to become uninsured, but would cut federal spending by at least $100 billion over a decade.