Republican leaders defended the changes to Medicaid arguing that there is currently a group of people who should not qualify, since they can work, but choose to stay home and Relax.

“There are almost 5 million able-bodied people who are on Medicaid and just choose not to work,” conservative political strategist, commentator, and author Scott Jennings recently said on “CNN News Night with Abby Phillip.” "They spend six hours a day socializing and watching TV. And if you can't get off Grandma's couch and go to work, I don't want to pay your welfare," he added.

These comments are added to those of the administrator of the Centers for Medicare and Medicaid Services, Mehmet Oz, who addressed the issue on Fox News: "When the program was created 60 years ago, nobody considered that people without disabilities who could work would be accepted and given access to Medicaid. Today, the average non-working, able-bodied person on Medicaid watches 6.1 hours of television or just hangs out.

Medicaid began as a federal-state health insurance program to cover medical care for low-income people.

Criteria for Qualifying for Medicaid

The current criteria for qualifying for Medicaid are primarily based on the following factors:

Low income: The allowable income threshold varies by household size and state, but generally in Medicaid expansion states, adults with incomes up to 138% of the federal poverty level (FPL) qualify. This threshold is adjusted based on the number of people in the family.

Number of Household Members: The income The maximum eligibility thresholds increase as household size grows, and each state sets specific thresholds.

Age: This is intended for groups such as children, adults 65 and older, and pregnant women.

Disability:People with disabilities are also eligible under specific conditions.

Residency and Citizenship: You must be a US citizen or permanent/lawful resident in the state where you apply. It is noteworthy that some states allow some access to non-citizens under specific conditions.

Recent Changes

Significant adjustments have been implemented during 2025. States are required to review the eligibility of expansion beneficiaries every six months (previously annually) to ensure they remain eligible.

Retroactive coverage has been reduced from three months to just one month prior to application.

Net worth thresholds for housing to disqualify people from long-term care have been increased from $750,000 to $1 million.

Similarly, there have been adjustments to income tests and other administrative reviews to improve accuracy and prevent eligibility inconsistencies.

These changes are argued to balance program expansion with more rigorous controls to ensure that Medicaid serves those who truly meet the criteria.