Some Medicaid recipients in Alabama may be required to work

Medicaid health care money

According to Gov. Kay Ivey and state Medicaid officials, Alabama is hoping to become the newest state to institute a work requirement for some Medicaid recipients.

As part of her General Fund Budget proposal, Ivey instructed Alabama’s Medicaid Commissioner Stephanie Azar to develop a policy for implementing a work requirement for Medicaid receivers. All work requirements would only be applicable to “able-bodied” adults, with exemptions being made for the elderly, people with disabilities, and children. Ivey’s current plan would also require copay increases for Medicaid recipients.

Her goal is to “increase efficiency and decrease costs related to Medicaid, all in an effort to be good stewards of taxpayer dollars…I look forward to future implementation of those policies.” 

This proposal comes after President Donald Trump‘s Administration sent a letter to all state Medicaid directors notifying them that they would allow states to impose work requirements on non-disabled working age Medicaid recipients. However, a work requirement is not the only option suggested by the Trump Administration. Recipients may also volunteer, attend a school or enter a work training program.

Earlier in January, Bryant-Republican State Rep. Tommy Hanes pre-filed HB6, which would also require able-bodied adults who are recipients of the Supplemental Nutrition Assistance Program (SNAP) , formerly known as food stamps, to participate in a work requirement with similar guidelines to the proposed medicaid work requirements.

According to the Lagniappe; “Alabama’s Medicaid costs took up one-third of the current General Fund budget, and the program is routinely the most expensive item lawmakers have to fund…despite that, a recent report from the Medicaid and CHIP Payment and Access Commission found Alabama already runs the leanest program of any state based on the average medical benefit received by its enrollees.”

Alabama has approximately 1.043 million Medicaid recipients, with over half of recipients being children, and only 18 percent being non-disabled adults.

Several other Republican majority states are seeking similar Medicaid work waivers, with Kentucky being the first state to move forward with the work requirements. 


  1. What an incentive. Prerequisite for all “able-bodied” adults receiving Medicaid or Supplemental Nutrition Assistance Program (SNAP) recipients. Get with the program in some manner or be eliminated from receiving continued assistance. Following lead of Kentucky who has had enough.

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