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Why Medicaid work requirements won't work
Gulf Today
|June 07, 2025
The US labour market is a truly astonishing thing to behold. It includes 171 million Americans, as young as 14 and older than 90, some who never finished elementary school and others with PhDs. It is resilient and dynamic, shrinking during recessions but growing again after. It provides the majority of Americans with the majority of their income. All of which is to say: It is common to look to the labor market as a kind of salve for all economic wounds. Whatever the problem is, the solution is to get people working. Unfortunately, it's not that simple. For all its strength, the labor market is encumbered by the low-wage labor market — where work doesn't support a stable living, and where jobs are so bad they're more salt than salve. This is a reality that Republicans in Congress, in their current push to impose work requirements on Medicaid recipients, ignore. They are making policy for a labor market that doesn’t exist.
The “low-wage labor market” is a vague designation. It’s typically defined as those workers who have relatively or absolutely low hourly earnings, such as the bottom quintile or quarter of wage earners, or earners below some nominal wage cutoff. Whatever the definition, however, there are some aspects of the low-wage labor market that are obvious: The low-wage labor market is large. At least 39 million workers in the US earn less than $17 an hour, which is the equivalent of $35,360 annually. That is just below 1388 of the poverty threshold for a family of three — the income needed for parents to be eligible for Medicaid in states that expanded it under the Affordable Care Act. Earnings in the low-wage labor market are volatile. Earnings volatility measures change in wage income from one month to the next. Instability at both the very top and very bottom is so great that economists have a term for it: the “wild ride.” Recent research from the Brookings Institution's Hamilton Project shows that low-wage earners see more spikes and dips in income than any other group, with the dips being especia
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