“He has autism and epilepsy and is being made to compete for resources with able-bodied adults.”
For Immediate Release
June 9, 2025
Contact: Taylor Haulsee
WASHINGTON — When people who can work but refuse to do so and stay on Medicaid, it takes away resources from those who deserve and rely upon it – like the teenage son of Arkansas father Nick Stehle, who has severe autism and epilepsy and requires constant attention. The Wall Street Journal published Nick’s story last week, which touts the work requirements included in the One Big Beautiful Bill Act that will strengthen and preserve the program for those who need it.
“Yet thanks to ObamaCare’s Medicaid expansion, he is stuck on a multiyear waiting list for in-home care because able-bodied adults are competing for the same resources,” Arkansas father Nick Stehle wrote.
Read the full op-ed here or below:
Medicaid was created to help people like my son. He is 17, has severe autism and epilepsy, and needs constant attention. Yet thanks to ObamaCare’s Medicaid expansion, he is stuck on a multiyear waiting list for in-home care because able-bodied adults are competing for the same resources. Republicans in the Senate can help states fix this by strengthening the Medicaid work requirements in the One Big Beautiful Bill Act they’re about to pass.
ObamaCare gave states a financial incentive to treat able-bodied adults better than the disabled. The federal government gives states $9 for every $1 they spend on able-bodied adults, but only $1.33 for every dollar spent on children, people with disabilities, pregnant women and seniors. Drawn by the promise of so much federal money, Arkansas’s Democratic governor expanded Medicaid in 2013. The program now covers more than 230,000 able-bodied adults.
Because able-bodied adults bring so much money, Arkansas makes them a priority. We applied for in-home care in 2023, but state officials said it would take 10 years. Democrats are doing everything they can to keep my son on the wait list. They’re trying to frighten Republicans into abandoning work requirements by claiming they’re ineffective, unnecessary and cruel—none of which is true.
In 2018 the Trump administration gave Arkansas a waiver that let it require able-bodied adults without children to work part time as a condition of receiving Medicaid benefits. A federal judge struck down the waiver on procedural grounds 10 months after the policy began to phase in. Yet the work requirement already had strong results.
In less than a year, nearly 18,000 able-bodied adults increased their incomes enough to get off Medicaid. States should encourage people to replace government dependency with financial independence, protecting Medicaid for people like my son. But Democrats and their allies now claim there wasn’t a corresponding increase in the number of people working. They also claim that people left Medicaid because they didn’t know about the work requirement and therefore didn’t fill out the paperwork. All these false claims are intended to convince Republicans that work requirements are difficult for states to administer.
Yet Arkansas thought it was well worth the effort, sending out more than a million letters, emails, text messages and phone calls in 2018 alone to inform recipients about the requirement. And far from not filling out paperwork, fully 87% of the people who were removed from Medicaid had already increased their incomes, moved out of state or otherwise become ineligible for the program. This freed up resources for people like my son. Arkansas projected the changes would save at least $300 million a year, reflecting how few of those able-bodied adults worked. Though the left now says that 92% of Medicaid recipients are supposedly working, that claim is based on self-reported survey data from the Census, with state sample sizes as small as 41 people. Only one conclusion is possible: Democrats want able-bodied adults to continue getting the benefits intended for my son.
A work requirement for Medicaid would put my son first. The House version of the “one big beautiful bill” applies only to childless adults on Medicaid expansion. The Senate could do better by extending the work requirement to even more able-bodied adults—say, those without young kids. The Senate could go even further, ending the Medicaid funding formula that encourages states to sign up able-bodied adults at the expense of people with disabilities. But the work requirement is the bare minimum of what Republicans should pass. Able-bodied adults have blocked my son from care for too long.
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