{"id":554,"date":"2026-06-18T18:09:35","date_gmt":"2026-06-18T18:09:35","guid":{"rendered":"https:\/\/modernhomejournals.com\/?p=554"},"modified":"2026-06-18T18:09:35","modified_gmt":"2026-06-18T18:09:35","slug":"scientists-say-hhs-is-spinning-their-data-to-push-medicaid-work-requirements","status":"publish","type":"post","link":"https:\/\/modernhomejournals.com\/?p=554","title":{"rendered":"Scientists Say HHS Is Spinning Their Data to Push Medicaid Work Requirements"},"content":{"rendered":"
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The Trump administration is using a short policy brief with minimal citations to justify work requirements for Medicaid coverage. Some of the cited researchers say their work is being misinterpreted.<\/p>\n

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The brief represents a stark departure from the usual quality of work from the Department of Health and Human Services\u2019 top policy office, experts and former federal employees told NOTUS.<\/p>\n

One former Health Department official called the policy document \u201cvery disappointing.\u201d<\/p>\n

\u201cFrankly, I was appalled,\u201d said Richard Frank, who served as assistant secretary for planning and evaluation at HHS during the Obama administration. \u201cThe concern is that the political narrative was what took over.\u201d<\/p>\n

The , titled \u201cMedicaid Work Requirements Incentivize Employment and Are Estimated to Reduce Poverty,\u201d was written by political appointees and career employees within the Office of the Assistant Secretary for Planning and Evaluation.<\/p>\n

It was published in conjunction with the Centers for Medicare & Medicaid Services\u2019 interim final rule<\/u><\/span> on the implementation of an 80-hours-per-month work requirement<\/u><\/span> for able-bodied adult Medicaid enrollees and applicants. CMS touted the study in its early June press release announcing<\/u><\/span> the new rule.<\/p>\n

ASPE, though little known outside of HHS, is meant to serve as a principal adviser to the Health Secretary; the office generates research reports that play a critical role in developing department policy. (The assistant secretary role is currently vacant<\/u><\/span>.)<\/p>\n

Over the course of about four and a half pages, the Trump administration argues that Medicaid work requirements could reduce poverty for millions of people and increase employment by over 4 percentage points in the first five years of implementation, compared with unconditional cash transfers.<\/p>\n

\u201cRecent studies also show positive impacts on employment and earnings,\u201d it states.<\/p>\n

But the brief\u2019s conclusions are \u201cgrounded in unrealistic assumptions instead of evidence,\u201d said Michael Karpman, a researcher with the Urban Institute whose work was cited.<\/p>\n

The ASPE brief cites a study<\/u><\/span> Karpman co-authored titled, \u201cMany Working People Would Be Shut Out of Medicaid under Proposed Work Requirements: Findings from the Survey of Income and Program Participation.\u201d<\/p>\n

The brief does not describe the actual findings of that study. Instead, it uses it as a source of \u201cfactors that could impede the potential reach of this policy\u201d without specifying what those factors are. Had the brief fully cited his work, it might have drawn very different conclusions about work requirements, Karpman said.<\/p>\n

\u201cThis study really helps explain why opportunities to increase employment through work requirements are so limited,\u201d Karpman said.<\/p>\n

Another cited researcher told NOTUS he was concerned that the report drew overly broad conclusions using his relatively narrow research: Michael Webb researched the effectiveness of work requirements for the public housing program in Charlotte, North Carolina, and the ASPE brief uses his study to help bolster the claim that work requirements could increase employment among Medicaid participants nationwide.<\/p>\n

Webb said that while the brief didn\u2019t mischaracterize his study\u2019s findings<\/u><\/span>, he noted \u201ca lot of crucial differences\u201d between how the Charlotte Housing Authority implemented the program and how each state will likely implement these new Medicaid requirements. His findings attributed much of the public housing program\u2019s success to the availability of hands-on case managers and the city\u2019s healthy economy, which enabled participants to find jobs.<\/p>\n

\u201cHaving on-site support was really crucial,\u201d Webb said in a statement. \u201cIt\u2019s also important to note that the goal of the program was to get residents to participate in services \u2014 not to terminate them from the program.\u201d<\/p>\n

The brief cites only 10 outside sources to back up its findings \u2014 a small sampling of the research on the impacts of work requirements, which generally comes to a very different conclusion, Adrianna McIntyre, an assistant professor of health policy and politics at Harvard University, told NOTUS.<\/p>\n

\u201cThe most relevant and most recent research is being left out of their discussion,\u201d said McIntyre, who, along with another researcher, wrote a lengthy analysis<\/u><\/span> of the brief\u2019s shortcomings.<\/p>\n

An HHS spokesperson pointed to the brief\u2019s mention of an ASPE-commissioned review of the scientific literature on \u201cwork promotion strategies\u201d as evidence that the brief\u2019s authors considered more than the studies cited.<\/p>\n

The brief links to a that lists 132 studies on work-promotion strategies, though only seven of the listed programs involved work requirements and none mention Medicaid participants in the \u201cpopulation studied\u201d column.<\/p>\n

The brief itself does not seem to cite the studies listed in the appendix. The HHS spokesperson said via email that ASPE research briefs are intended to be \u201cconcise and accessible to readers,\u201d with supporting materials in appendices rather than in the body of the brief. ( have been .)<\/p>\n

Some of the studies included in the technical appendix seem to directly contradict the brief\u2019s findings. Among the studies about Supplemental Nutrition Assistance Program work requirements listed in the technical appendix \u2014 studies that the HHS spokesperson specifically pointed to, but which were not cited in the brief \u2014 one showed<\/u><\/span> \u201cno effects on employment,\u201d while the other<\/u><\/span> found that they \u201cmay increase the risk of disadvantaged individuals failing to receive the assistance they need.\u201d<\/p>\n

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Experts and former staff told NOTUS that while ASPE\u2019s work can be influenced by the political leanings of each administration, the office\u2019s many career staff generally ensure that its work remains grounded in evidence.<\/p>\n

This brief, they said, is different.<\/p>\n

\u201cI do think that it is a shame to use the office to push research that is this shoddy,\u201d McIntyre said.<\/p>\n

Karpman told NOTUS the brief leaves out research that doesn\u2019t support the conclusion that work requirements raise employment rates.<\/p>\n

\u201cThey cite selected studies on work requirements in [Temporary Assistance for Needy Families] and housing programs, which were implemented in a much different context,\u201d Karpman said. \u201cThey don\u2019t cite studies on SNAP and other literature showing no employment effects from work requirements.\u201d<\/p>\n

Notably, multiple experts said, there\u2019s an Arkansas-shaped hole in the brief: While several of the cited sources mention Arkansas, the first state to fully implement Medicaid work requirements, the state goes unmentioned by the ASPE brief.<\/p>\n

The Arkansas work requirements implemented during the first Trump administration were widely considered<\/u><\/span> a failure. More than 18,000 people \u2014 about 25% of the population subject to the requirements \u2014 lost coverage while they were in effect. The requirement was discontinued in 2019 after less than a year.<\/p>\n

\u201cIt\u2019s an enormous gap in this analysis, and it makes it very hard to view it at face value as anything other than a political effort,\u201d Benjamin Sommers, who was the senior official overseeing health policy at ASPE during the Biden administration, said of the brief\u2019s omission of Arkansas\u2019 implementation.<\/p>\n

Sommers, who is now a professor of health care economics at Harvard University, noted that the brief cited one study<\/u><\/span> by his team on Medicaid participation rates \u2014 but conspicuously omitted two<\/u><\/span> papers<\/u><\/span> he worked on that showed Arkansas saw no change in employment as a result of work requirements.<\/p>\n

\u201cThe assumptions here are just really implausible and outright ignore the evidence on Medicaid work requirements, and so I just don\u2019t think you can really put much stock in this at all,\u201d Sommers said.<\/p>\n

The HHS spokesperson said via email that the review \u201cfocused on studies that received moderate or high ratings on methodological rigor\u201d based on a government research clearinghouse<\/u><\/span>. They added that Sommers\u2019 2020 study<\/u><\/span> on work requirements in Arkansas used a study design that was \u201cassessed as not sufficient,\u201d and was therefore not included. (Sommers strongly disputed this assessment.)<\/p>\n

Two of the cited authors told NOTUS that their research was correctly characterized, but otherwise didn\u2019t comment on the brief\u2019s conclusions.<\/p>\n

The brief also models the potential effects of the new Medicaid work requirements \u2014 one with perfect implementation and one with less-than-perfect enrollment, employment rate and coverage. But those scenarios don\u2019t reflect reality, said McIntyre, the Harvard University health policy expert.<\/p>\n

\u201cThis is what I call a \u2018sunshine and rainbows\u2019 approach to analysis,\u201d McIntyre said. \u201cIt\u2019s basically ignoring everything we know about how work requirements operate in practice to say, \u2018Well, what could they do if we ignore all of the evidence?\u2019\u201d<\/p>\n

The brief acknowledges that the modeling scenarios are limited in their usefulness.<\/p>\n

\u201cOur results should be interpreted as approximate estimates rather than precise point estimates,\u201d it states.<\/p>\n

The HHS spokesperson said via email, \u201cThe purpose of the simulations is to illustrate the full potential of the policy when implemented as intended and to highlight poverty reduction as a key objective. The Trump Administration and HHS are committed to helping individuals move toward greater economic stability and self-sufficiency.\u201d<\/p>\n

This is not the first time an HHS report produced during the Trump administration has used questionable methods to back up scientifically dubious claims. A report from the Make America Healthy Again Commission published last year included fabricated citations, as NOTUS first reported<\/u><\/span>.<\/p>\n

There has been some indication that the administration is trying to improve its research standards. A recent advisory on the dangers of screen time was transparent that generative AI in its production.<\/p>\n

But several of the former HHS officials and experts who spoke to NOTUS said they were concerned that this brief indicates a loosening of standards at a federal research office known for producing work grounded in evidence.<\/p>\n

\u201cGoing back to the Bush administration, the Clinton administration, both Bushes \u2014 there was always a basic credibility,\u201d Frank said. \u201cWhen you kind of make up the assumptions, and you don\u2019t rely on data, and you don\u2019t rely on evidence, and you in fact put out the evidence and then ignore it \u2014 that goes to the credibility of the exercise, and that\u2019s very damaging.\u201d<\/p>\n

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A government report ignored evidence and misinterpreted research.<\/p>\n","protected":false},"author":1,"featured_media":553,"comment_status":"open","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[1],"tags":[],"class_list":["post-554","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-interesting"],"yoast_head":"\nScientists Say HHS Is Spinning Their Data to Push Medicaid Work Requirements - Modern Home Journals<\/title>\n<meta name=\"robots\" content=\"index, follow, max-snippet:-1, max-image-preview:large, max-video-preview:-1\" \/>\n<link rel=\"canonical\" href=\"https:\/\/modernhomejournals.com\/?p=554\" \/>\n<meta property=\"og:locale\" content=\"en_US\" \/>\n<meta property=\"og:type\" content=\"article\" \/>\n<meta property=\"og:title\" content=\"Scientists Say HHS Is Spinning Their Data to Push Medicaid Work Requirements - Modern Home Journals\" \/>\n<meta property=\"og:description\" content=\"A government report ignored evidence and misinterpreted research.\" \/>\n<meta property=\"og:url\" content=\"https:\/\/modernhomejournals.com\/?p=554\" \/>\n<meta property=\"og:site_name\" content=\"Modern Home Journals\" \/>\n<meta property=\"article:published_time\" content=\"2026-06-18T18:09:35+00:00\" \/>\n<meta name=\"author\" content=\"admin\" \/>\n<meta name=\"twitter:card\" content=\"summary_large_image\" \/>\n<meta name=\"twitter:label1\" content=\"Written by\" \/>\n\t<meta name=\"twitter:data1\" content=\"admin\" \/>\n\t<meta name=\"twitter:label2\" content=\"Est. reading time\" \/>\n\t<meta name=\"twitter:data2\" content=\"8 minutes\" \/>\n<script type=\"application\/ld+json\" class=\"yoast-schema-graph\">{\"@context\":\"https:\\\/\\\/schema.org\",\"@graph\":[{\"@type\":\"Article\",\"@id\":\"https:\\\/\\\/modernhomejournals.com\\\/?p=554#article\",\"isPartOf\":{\"@id\":\"https:\\\/\\\/modernhomejournals.com\\\/?p=554\"},\"author\":{\"name\":\"admin\",\"@id\":\"https:\\\/\\\/modernhomejournals.com\\\/#\\\/schema\\\/person\\\/533de239efc09a2ab59959cc1bff86d0\"},\"headline\":\"Scientists Say HHS Is Spinning Their Data to Push Medicaid Work Requirements\",\"datePublished\":\"2026-06-18T18:09:35+00:00\",\"mainEntityOfPage\":{\"@id\":\"https:\\\/\\\/modernhomejournals.com\\\/?p=554\"},\"wordCount\":1639,\"commentCount\":0,\"image\":{\"@id\":\"https:\\\/\\\/modernhomejournals.com\\\/?p=554#primaryimage\"},\"thumbnailUrl\":\"https:\\\/\\\/modernhomejournals.com\\\/wp-content\\\/uploads\\\/2026\\\/06\\\/aa5cbb120e4cb71ffe8819954d909c3e-scaled.jpg\",\"articleSection\":[\"Interesting\"],\"inLanguage\":\"en-US\",\"potentialAction\":[{\"@type\":\"CommentAction\",\"name\":\"Comment\",\"target\":[\"https:\\\/\\\/modernhomejournals.com\\\/?p=554#respond\"]}]},{\"@type\":\"WebPage\",\"@id\":\"https:\\\/\\\/modernhomejournals.com\\\/?p=554\",\"url\":\"https:\\\/\\\/modernhomejournals.com\\\/?p=554\",\"name\":\"Scientists Say HHS Is Spinning Their Data to Push Medicaid Work Requirements - Modern Home Journals\",\"isPartOf\":{\"@id\":\"https:\\\/\\\/modernhomejournals.com\\\/#website\"},\"primaryImageOfPage\":{\"@id\":\"https:\\\/\\\/modernhomejournals.com\\\/?p=554#primaryimage\"},\"image\":{\"@id\":\"https:\\\/\\\/modernhomejournals.com\\\/?p=554#primaryimage\"},\"thumbnailUrl\":\"https:\\\/\\\/modernhomejournals.com\\\/wp-content\\\/uploads\\\/2026\\\/06\\\/aa5cbb120e4cb71ffe8819954d909c3e-scaled.jpg\",\"datePublished\":\"2026-06-18T18:09:35+00:00\",\"author\":{\"@id\":\"https:\\\/\\\/modernhomejournals.com\\\/#\\\/schema\\\/person\\\/533de239efc09a2ab59959cc1bff86d0\"},\"breadcrumb\":{\"@id\":\"https:\\\/\\\/modernhomejournals.com\\\/?p=554#breadcrumb\"},\"inLanguage\":\"en-US\",\"potentialAction\":[{\"@type\":\"ReadAction\",\"target\":[\"https:\\\/\\\/modernhomejournals.com\\\/?p=554\"]}]},{\"@type\":\"ImageObject\",\"inLanguage\":\"en-US\",\"@id\":\"https:\\\/\\\/modernhomejournals.com\\\/?p=554#primaryimage\",\"url\":\"https:\\\/\\\/modernhomejournals.com\\\/wp-content\\\/uploads\\\/2026\\\/06\\\/aa5cbb120e4cb71ffe8819954d909c3e-scaled.jpg\",\"contentUrl\":\"https:\\\/\\\/modernhomejournals.com\\\/wp-content\\\/uploads\\\/2026\\\/06\\\/aa5cbb120e4cb71ffe8819954d909c3e-scaled.jpg\",\"width\":2560,\"height\":1707,\"caption\":\"President Donald Trump, with Dr. Mehmet Oz, Administrator of the Centers for Medicare & Medicaid Services, left, and Health and Human Services Secretary Robert F. 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