"Workfare" and the Medicaid Morality Play.

The article focuses on the 2025 federal mandate (P.L. 119-21) instituting work requirements for Medicaid eligibility, marking a shift from Medicaid’s traditional status as a non-work-conditioned program. It traces the historical and ideological roots of "workfare" policies, which condition social benefits on labor market participation, highlighting prior evidence from Arkansas’s Medicaid work requirement waiver that led to significant coverage losses without employment gains. The mandate requires adults aged 19–64 to engage in 80 hours per month of work or community activities, with specified exemptions, and is projected to cause millions of coverage losses and adverse health outcomes. The article emphasizes the ethical tensions this policy raises for social workers and health advocates, arguing that conditioning healthcare on employment undermines dignity and public health, and calls for careful implementation to minimize harm. [Extracted from the article]