Trump Administration Sends Mixed Messages on Welfare Work Rules

WASHINGTON—The Trump administration issued guidelines Thursday to help states impose the first-ever work requirements on Medicaid beneficiaries, one of the biggest changes in the program’s 50-year history.

That approach contrasts with a move the administration made with less fanfare earlier in the week to extend waivers that allow food-stamp recipients in 33 states to avoid work requirements.

The different approaches reflect the complex political forces that surround safety-net programs. Many conservatives argue that people shouldn’t receive government aid without working if they can, but officials in some states want to spare their residents such requirements.

The new work guidelines issued by the Centers for Medicare and Medicaid Services aim to transform Medicaid, in states seeking a program revamp, from a guaranteed benefit based on income to a program that can deny aid to many adults if certain conditions aren’t met. States can determine what can qualify as work under the requirements, such as education or community service.

“This is in response to proposals we are receiving from states,” said Seema Verma, who heads CMS. “This effort is about helping people rise out of poverty.”

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