Ohio previously received federal approval for a similar proposal in 2019, only to have that approval revoked by the Biden administration in 2021. Public comments on the state’s latest request will end in April.

Approving states’ Medicaid work requirements was a major priority of the first Trump administration, though House Republicans are currently weighing whether to nationalize work requirements, even in blue states. 

House Republicans have advanced a budget resolution calling for at least $2 trillion in spending cuts to help pay for President Trump’s agenda. Under the resolution, the House Energy and Commerce Committee, which oversees Medicaid, has been tasked with identifying at least $880 billion in cuts to programs under its jurisdiction.

Medicaid work requirements are one of the possibilities being considered, though nothing has been formally proposed.  

Under a previously proposed GOP policy, states would lose federal Medicaid funding for able-bodied adults ages 19 to 55 without dependents if those recipients fail to meet the work requirement for three or more months during a calendar year.  

Republicans who favor work requirements argue that too many Americans are dependent on Medicaid and other safety net programs and view work requirements as promoting self-sufficiency. 

“Reinstating our work requirement will promote self-sufficiency, it will give more people the purpose and pride that comes with a job, and it will improve the well-being of Ohio’s workforce,” Gov. Mike DeWine (R) said in a statement.  

Under Ohio’s proposal, Medicaid expansion enrollees would need to be at least age 55, or be employed, be enrolled in school or a job training program, be in a recovery program, or have a serious physical or mental health illness to receive benefits. 

Ohio expanded Medicaid under former GOP Gov. John Kasich to people earning up to 138 percent of the poverty level. That’s the population being targeted by the new requirements. Many Republicans refer to the Medicaid expansion population as “able-bodied,” a term implying they need less government assistance than the traditional Medicaid population.