Give Medicaid Work Rules a Try — Carefully

Healthy enough to work?

Photographer: Andrew Harrer/Bloomberg

Requiring some Medicaid recipients to work is not the worst idea to come out of Donald Trump's administration. It might nudge some beneficiaries toward more productive lives, and it could help subdue persistent sentiment that the program allows adults who should be working to get free health insurance at taxpayers' expense.

But these aspirations will not be realized unless there is strict oversight. If the federal government wants to allow states to require their Medicaid beneficiaries to work, then it also has to ensure that anyone truly unable to do so does not lose Medicaid.

These proposed rules — essentially a waiver that would allow states to require not only work but also job training or volunteering — cannot be used as a tool to minimize insurance coverage. In a country where 8.8 percent of the population still lacks health insurance, the goal should be to expand coverage, not shrink it.