Details

Written by: Anne Whitesell, Miami University

Published: 28 May 2025

Republican lawmakers have been battling over a bill that includes massive tax and spending cuts. Much of their disagreement has been over provisions intended to reduce the cost of Medicaid.

The popular health insurance program, which is funded by both the federal and state governments, covers about 78.5 million low-income and disabled people – more than 1 in 5 Americans.

On May 22, 2025, the House of Representatives narrowly approved the tax, spending and immigration bill. The legislation, which passed without any support from Democrats, is designed to reduce federal Medicaid spending by requiring anyone enrolled in the program who appears to be able to get a job to either satisfy work requirements or lose their coverage. It’s still unclear, however, whether Senate Republicans would support that provision.

Although there are few precedents for such a mandate for Medicaid, other safety net programs have been enforcing similar rules for nearly three decades. I’m a political scientist who has extensively studied the work requirements of another safety net program: Temporary Assistance for Needy Families.

As I explain in my book, “Living Off the Government? Race, Gender, and the Politics of Welfare,” work requirements place extra burdens on low-income families but do little to lift them out of poverty.

Work requirements for TANF

TANF gives families with very low incomes some cash they can spend on housing, food, clothing or whatever they need most. The Clinton administration launched it as a replacement for a similar program, Aid to Families with Dependent Children, in 1996. At the time, both political parties were eager to end a welfare system they believed was riddled with abuse. A big goal with TANF was ending the dependence of people getting cash benefits on the government by moving them from welfare to work.

Many people were removed from the welfare rolls, but not because work requirements led to economic prosperity. Instead, they had trouble navigating the bureaucratic demands.

TANF is administered by the states. They can set many rules of their own, but they must comply with an important federal requirement: Adult recipients have to work or engage in an authorized alternative activity for at least 30 hours per week. The number of weekly hours is only 20 if the recipient is caring for a child under the age of 6.

The dozen activities or so that can count toward this quota range from participating in job training programs to engaging in community service.

Some adults enrolled in TANF are exempt from work requirements, depending on their state’s own policies. The most common exemptions are for people who are ill, have a disability or are over age 60.

To qualify for TANF, families must have dependent children; in some states pregnant women also qualify. Income limits are set by the state and range from US$307 a month for a family of three in Alabama to $2,935 a month for a family of three in Minnesota.

Adult TANF recipients face a federal five-year lifetime limit on benefits. States can adopt shorter time limits; Arizona’s is 12 months.

 

An administrative burden

Complying with these work requirements generally means proving that you’re working or making the case that you should be exempt from this mandate. This places what’s known as an “administrative burden” on the people who get cash assistance. It often requires lots of documentation and time. If you have an unpredictable work schedule, inconsistent access to child care or obligations to care for an older relative, this paperwork is hard to deal with.

What counts as work, how many hours must be completed and who is exempt from these requirements often comes down to a caseworker’s discretion. Social science research shows that this discretion is not equally applied and is often informed by stereotypes.

The number of people getting cash assistance has fallen sharply since TANF replaced Aid to Families with Dependent Children. In some states caseloads have dropped by more than 50% despite significant population growth.

Some of this decline happened because recipients got jobs that paid them too much to qualify. The Congressional Budget Office, a nonpartisan office that provides economic research to Congress, attributes, at least in part, an increase in employment among less-educated single mothers in the 1990s to work requirements.

Not everyone who stopped getting cash benefits through TANF wound up employed, however. Other recipients who did not meet requirements fell into deep poverty.

Regardless of why people leave the program, when fewer low-income Americans get TANF benefits, the government spends less money on cash assistance. Federal funding has remained flat at $16.5 billion since 1996. Taking inflation into account, the program receives half as much funding as when it was created. In addition, states have used the flexibility granted them to direct most of their TANF funds to priorities other than cash benefits, such as pre-K education.

Many Americans who get help paying for groceries through the Supplemental Nutrition Assistance Program are also subject to work requirements. People the government calls “able-bodied adults without dependents” can only receive SNAP benefits for three months within a three-year period if they are not employed.

A failed experiment in Arkansas

Lawmakers in Congress and in statehouses have debated whether to add work requirements for Medicaid before. More than a dozen states have applied for waivers that would let them give it a try.

When Arkansas instituted Medicaid work requirements in 2018, during the first Trump administration, it was largely seen as a failure. Some 18,000 people lost their health care coverage, but employment rates did not increase.

After a court order stopped the policy in 2019, most people regained their coverage.

Georgia is currently the only state with Medicaid work requirements in effect, after implementing a waiver in July 2023. The program has experienced technical difficulties and has had trouble verifying work activities.

Other states, including Idaho, Indiana and Kentucky, are already asking the federal government to let them enforce Medicaid work requirements.

What this may mean for Medicaid

The multitrillion-dollar bill the House passed 215-214 would introduce Medicaid work requirements nationwide by late 2026 for childless adults age 19 to 64, with some exemptions.

But most people covered by Medicaid in that age range are already working, and those who are not would likely be eligible for work requirement waivers. An analysis by KFF – a nonprofit that informs the public about health issues – shows that in 2023, 44% of Medicaid recipients were working full time and another 20% were working part time. In 2023, that was more than 16 million Americans.

About 20% of the American adults under 65 who are covered by Medicaid are not working due to illness or disability, or because of caregiving responsibilities, according to KFF. This includes both people caring for young children and those taking care of relatives with an illness or disability. In my own research, I read testimony from families seeking work exemptions because caregiving, including for children with disabilities, was a full-time job.

The rest of the adults under 65 with Medicaid coverage are not working because they are in school, are retired, cannot find work or have some other reason. It’s approximately 3.9 million Americans. Depending on what counts as “work,” they may be meeting any requirements that could be added to the program.

The Congressional Budget Office estimates that introducing Medicaid work requirements would save around $300 billion over a decade. Given past experience with work requirements, it is unlikely those savings would come from Americans finding jobs.

My research suggests it’s more likely that the government would trim spending by taking away the health insurance of people eligible for Medicaid coverage who get tangled up in red tape.

This article was updated on May 22, 2025, with details about the House of Representatives’ passage of the budget bill.

Anne Whitesell, Assistant Professor of Political Science, Miami University

This article is republished from The Conversation under a Creative Commons license. Read the original article.

Details

Written by: LAKE COUNTY NEWS REPORTS

Published: 27 May 2025

CLEARLAKE, Calif. — Considered the biggest of its kind west of the Mississippi, the three-day Catfish Derby in Clearlake Oaks closed to cheers on Sunday, May 18, the last day of the event. 

Two local youngsters and one big winner from Marysville took home the top cash prizes.

“By noon on Friday, when the fishing began, we had registered 949 adults and children from around the State and beyond,” said Derby Chair Dennis Locke. “Another year of excellent lake conditions helps explain the turnout and no doubt news of the record-breaking 37.04 pound catfish caught last September helped too.”

On hand to show their support for the Derby were District 3 Supervisor E.J. Crandall, District Attorney Susan Krones, Sheriff Luke Bingham and Congressman Mike Thompson’s representative, Luca Morretti. 

The group took in the festivities and spent time talking with local volunteers and anglers about the Derby. 

Additionally, a small crew of fire fighters from Cal Fire dropped in as well as other friends of the Derby — including the Purple Queens raising awareness of lupus and sex trafficking. 

Matthew St. Clair, president of the Clearlake Oaks-Glenhaven Business Association, his wife Stacy and their son and mascot, Henry, attended and worked all three days. 

About 80 volunteers work the three-day tournament, with a core group meeting 8 months out of the year to plan the event that draws well over 1,000 visitors who shop, eat, and stay in local business establishments. 

The derby is sponsored by the Clearlake Oaks-Glenhaven Business Association.

“I don’t have the final tally, but it’s safe to say we raised more than $30,000 this year — all of which will go right back into the community to support schools, sports, elders and various other activities,” Locke said.

Clear Lake is known as a premier bass fishing lake with tournaments held year-round. Local sportswriter Terry Knight has often said that the Catfish Derby is by far the largest tournament on the Lake. 

“Judging by the turnout this year, I’d say he’s right,” said Locke. “And this year, we registered 180 kids — more youngsters than ever. 

The Catfish Derby has a long history, beginning as a small affair in Clearlake Oaks in 1978. “We skipped a few years but have been going strong for at least 41 years,” Locke said. 

Sue and Jim Burton, well known for their community advocacy, were on hand to help out. “Jim and I have attended, and volunteered, from the very beginning,” Sue said. “The derby has changed — in size — from about 100 when we kicked off to nearly 1,000 in recent years. But the spirit of the event is not so different. Everyone has a good time, many returning year after year. We love it, especially the way it brings families together. But what I love the most is the kids, seeing the smiles and excitement on their faces tops everything.”

Known for its draw to families, this year’s top winners all attended and fished as family units.
Jerry Bybee from Marysville took the top prize, $5,000 cash, with his 28.31 pound catfish. Jerry’s brothers, J.C. and Tim also attended, along with their wives and kids.

In the kid divisions, two locals captured first place. Six-year-old Alaya Valencia from Clearlake won in the 10 and under division; 12-year-old Scarlett Reordan from Lakeport won in the 11- to 15-year group. Each took home cash prizes of $100.

Alaya’s mom, Chelsea Valencia, said Alaya began fishing with her dad, Shane, as a toddler. “First on ocean-going party boats and by 3 she was fishing for catfish in Clear Lake as a registered participant,” she said. 

Alaya caught her winning 21.93 pound catfish while shore fishing with her sister, Lexi, who placed 3rd in the 11- to 15-year division. 

During the tournament, Valencia was shuttling Lexi back and forth from softball to the Derby. “The credit for the girl’s interest in fishing goes to dad,” she said. “I’m the booster, supporting them all as they enjoy their fishing experiences and happy to do it.”

Scarlett Reordan began fishing in the Derby in 2021. “But she’s been around fishing since she was 4 years old,” said her aunt, Michelle Ladd. “She went into the derby this year very determined to win.”  

Ladd recalled how in the first few years Scarlett would go out for a few hours on the first and second day of the derby. 

“Now she’s out all day and night with the guys. In fact, Scarlett caught this year’s winning 22.35 pound  fish in the middle of the night. She also won 1st place last year with a 20.82 pound fish,” Ladd said.

“I don’t fish, but I’m there to help out and provide support. At this point, I’d say she’s a hard-core fishing enthusiast. My husband, Ron, and I have really enjoyed watching her skills improve and her competitive nature develop,” Ladd said. 

The Bybee family has fished the Derby for 18 years and plans to return next year. First place winner Jerry Bybee; his two brothers, J.C., and Tim; and their families rent several houses in Clearlake and stick together throughout the event, fishing and enjoying their time at the Derby. 

“We’re a group of 15,” Jerry Bybee said. “My brothers have also placed in prior years; J.C. has placed 3rd and Tim 2nd. Also, my nephew, Waylon, placed 7th in the adult division in 2023. It’s definitely a family tradition.”

Bybee said the fishing trips started out as more of a guy thing. “Since we’ve added our families to the mix we’ve had a lot more fun. My wife, Alma, has fished with us for 10 years.”

“We come as a family to enjoy fishing, the lake and being together. I love it – we all love it.  Watching our kids fish with their cousins keeps us coming back to the Derby. It’s a fun and wholesome activity for them to engage in,” Alma Bybee said.
 
Jerry Bybee’s winning fish topped last year’s 1st place winner by just over a half pound. “I’m pleased with my catch, I’d like to go bigger — maybe next year,” he said.

A total of $10,000 cash prizes were distributed. “Everyone who placed — 20 adults and 10 kids, deserves recognition and encouragement to come back for a try at a bigger fish,” Locke said. 

There were many regulars and newcomers this year. The majority of the derby entries were from outside of the county, 53%, compared to 47% within the county.

Gail Jonas, former derby chair, dropped in to cheer on the winners. Along with Gail’s husband Jim, Mike Dean has been on hand regularly to help record the fish weights. “I never get tired of volunteering for the Derby,” Dean said. 

While the final details were being attended to Locke, the chief volunteer, dropped what he was doing to make sure Logan Meleskie, who placed ninth with his 25.05 pound fish, got his check before heading out for his six-hour drive home.

“It’s Logan’s birthday – we couldn’t let him go without his cash prize,” Locke said.

As Meleskie headed home to Fresno, he shouted, “I’ll be back, I’ve already booked my stay for next year.”

Locke, who took over as chair when Gail Jonas stepped down, announced that the 42nd Derby would be under new leadership. “Matthew St. Clair has been working side by side with me this year and is ready to take over. I know he’ll do an outstanding job.”

Details of all wins and a host of photos can be found on www.clearlakeoaks.org/derby and on Facebook, Catfish Derby at the Oaks, where many impromptu photos and videos are posted. 

Details

Written by: Edward Lempinen

Published: 27 May 2025

A plan to impose historic cuts on the federal Medicaid program could lead millions of low-income Californians to lose health care coverage and cause a cascade of negative health and economic impacts across the state, according to analyses authored by UC Berkeley experts.

Almost four in 10 Californians rely on Medi-Cal for their health care, says a report by Miranda Dietz, Nari Rhee and Laurel Lucia at the UC Berkeley Labor Center. 

Before the measure was approved last week in the U.S. House of Representatives, the researchers cited an external study showing that 2.3 million to 3.5 million Medi-Cal recipients could be at risk.

“We know just how important Medi-Cal is for our state, what an integral part of our health care system it is — from the coverage it provides to millions of people, to the support it gives to health care providers and health care workers, and then just the overall impact that those federal dollars have on our economy,” said Dietz. “This would be a major cut that really would impact all of us.”

The budget plan sent to the U.S. Senate for action would impose requirements that most Medicaid recipients hold a job or attend school, and regularly document their work and schooling. 

But most adults receiving Medi-Cal already work or attend school, the Labor Center report says, and the reporting requirements threaten to tangle them in bureaucratic red tape.

The proposed new requirements could lead to confusion, delays — and cancelled coverage.

A cascade of harmful impacts to health and economies

The measure passed last week as part of the Republicans’ “One Big, Beautiful Bill” represents the toughest restrictions ever placed on federal Medicaid programs. 

Reporting requirements would be more demanding, and recipients who don’t meet the requirements would find it more difficult to re-enroll. Fewer recipients would be exempt from the rules.

The Labor Center, a branch of the Berkeley Institute for Research on Labor and Employment, has extensively studied the health, economic and policy aspects of Medi-Cal. Recent research has detailed the impact of potentially massive federal cuts.

The harm would extend beyond recipients: The health of their children also could suffer as families fall deeper into stress. Health care networks could lose essential revenue, especially in rural areas such as the Central Valley, where a high share of residents are enrolled in Medi-Cal. Health facilities might shrink or close. Tens of thousands of doctors, nurses and other health workers could lose their jobs, and the lost income and reduced spending could lead to economic harm throughout those communities.

A separate report by Lucia last month said federal cuts to Medicaid funding could lead over time to the loss of 109,000 to 217,000 health care jobs in California, while reducing state and local tax revenues by up to $1.7 billion.

The Medi-Cal program relies on both state and federal funds, and California Gov. Gavin Newsom, a Democrat, is also proposing to scale back some Medi-Cal benefits. But the federal cuts proposed by Republicans would be massive: The most recent estimates by the Congressional Budget Office projected more than $800 billion in cuts over the next 10 years.

The measure requires recipients of federal Medicaid dollars to document 80 hours per month of work, public service or school. Some groups would be exempted — parents of minor children, for example, or people with disabilities, complex medical conditions or substance abuse issues.

But most of the adults at risk of losing health care are already working, the Berkeley authors report. They cite a Kaiser Family Foundation study showing that 63% of adult Medi-Cal recipients hold paying jobs; another 29% can’t work because of family caregiving responsibilities, because they’re in school or because of an illness or disability.

The proposals under negotiation in Washington are intentionally “adding red tape to get people to fall off” the Medicaid rolls, said Dietz. “Requiring people to renew their eligibility every six months rather than every 12 months — that's twice the amount of paperwork, and twice the chance for people to fall off because something gets lost in the mail.”

Cautionary tales: Arkansas, New Hampshire and Georgia

Arkansas and New Hampshire have taken a similar approach in recent years, the authors wrote.

When Arkansas became the first state in the nation to institute work requirements in 2018, some 18,000 adult recipients were knocked off the rolls within six months. A federal judge ended the work requirement in March 2019.

The Berkeley authors wrote that a subsequent study in the New England Journal of Medicine found that most people targeted by the Arkansas policy “had never heard of it, were confused about whether it applied to them, or had difficulty accessing assistance related to reporting requirements.”

The New Hampshire program soon met a similar fate.

Georgia in 2023 imposed strict work requirements on Medicaid recipients, and enlisted a vintage-car mechanic to endorse the initiative in a glossy media campaign. Within months, however, the mechanic’s health policy had been cancelled twice by bureaucratic red tape, and the mechanic went public with his frustration.

“Other states’ experiences demonstrate that work requirements do not increase employment among enrollees,” the Labor Center report said. “Instead, their onerous documentation requirements increase administrative costs and reduce enrollment and access to care, including for people who are already working or otherwise should be exempt.

“For policymakers interested in encouraging employment, this reduction in care access is counterproductive: Research shows that access to health care improves individuals’ ability to find and keep jobs.”

The threat to California’s rural communities

Dietz is a senior policy researcher at the Labor Center and a project director for the California Simulation of Insurance Markets initiative. In an interview, she said the consequences of deep Medicaid cuts could be “devastating” in the state’s rural regions.

While 38% of Californians are supported by Medicaid funding, in some parts of the Central Valley more than half of the population is enrolled in Medi-Cal.

That’s also the case in Lake County, where officials have reported 54% of residents are on Medi-Cal.

“Rural hospitals are deeply reliant on Medi-Cal for their funding,” Dietz explained. “If that funding gets cut, or the number of people coming through the door with Medi-Cal goes down, then they have more uncompensated care that they're providing. That would make it harder for them to stay open or shut down services.

“That means that for all of us, that hospital or that particular department would not be available.”

But, Dietz said, if less health care is available for people in need, the implications are clear.

“Very simply, Medicaid saves lives,” she said. “There's good evidence on this now, with economists confirming that if you have comprehensive health insurance coverage, you're more likely to get the care that you need. You're less likely to die.

“So there could be huge impacts for the folks who wind up uninsured as a result of these policies.”

Edward Lempinen writes for the UC Berkeley News Center.