ABLE-BODIED

The deceptive phrase behind Trump's Medicaid purge

- Julia Métraux

A FEW DAYS before the passage of Trump's One Big Beautiful Bill, the White House released a “Myth vs. Fact” document to counter criticism of the inclusion of work requirements for Medicaid eligibility. The proposed new rules need not cause worry among Americans, the document implied, because only “able-bodied adults” would have to show proof of employment. In return, the administration claimed, the needy would gain something beyond mere federal health coverage: dignity.

For decades, Republicans (and austere liberals) have deployed the “able-bodied” trope to sell the public on employment as a condition of government assistance. In this context, the expression brings to mind capable workers glued to their sofas—“couch potatoes,” as the former Florida Rep. Matt Gaetz once put it—eating junk food and playing video games while living on the government dole.

Putting aside the fact that nobody gets rich from the ability to see a doctor, the rhetoric is confounding. What does “able-bodied” mean?

It isn’t a term typically used by medical professionals. And the phrase is not, in fact, indicative of a vast slouching class—lots of disabled people have jobs. The vast majority of adult Medicaid recipients who can work already do; KFF reports that nearly two-thirds of those not enrolled in the Social Security disability programs are working full or part time. Most nonworking recipients have legitimate excuses, including retirement, caregiving, school, or an illness.

“Able-bodied” may sound like a medical determination but, as activist Imani Barbarin told me, it’s really just a vague way “to signal this idea that disability can be seen.” Under this rubric, people with invisible disabilities that can make work extremely challenging—including psychiatric disabilities like bipolar disorder or chronic illnesses such as lupus—can be cast as lazy.