Armond Dai has been grappling with the debilitating effects of Long Covid since his second infection in September 2023. By December of that year, his symptoms became severe enough to compel him to leave his job in architectural design. Since March, he has relied on Medicaid for support.
Dai, who resides in California, is among a growing number of chronically ill and disabled individuals facing new work requirements imposed by a Medicaid overhaul included in President Donald Trump’s controversial tax and spending bill from July. Under these rules, which will come into effect by January 2027, Medicaid recipients could lose their benefits if they are unable to work at least 80 hours a month. For Dai, this means he must find a job that accommodates remote work, allows for later hours, and provides flexibility for medical appointments.
“Do I have hope that that job will appear?” Dai reflects. “I do not.”
The new work requirements, designed to fund substantial tax cuts for the wealthiest Americans, pose significant challenges for Medicaid users. Not only will these individuals likely need access to a healthcare provider to navigate the complexities of the system, but Health and Human Services Secretary Robert F. Kennedy Jr. will have the authority to define the parameters of the requirements, including which chronically ill and disabled individuals may qualify for exemptions.
The situation is further complicated by the Trump administration’s ongoing attacks on labor protections, particularly those that defend the rights of disabled workers. The White House has made it increasingly difficult for disabled and chronically ill individuals to find accessible employment, especially as many companies roll back their remote work policies—despite a persistent demand for flexible work arrangements—and as the job market experiences a downturn amid tariffs and slow economic growth.
Dawn Morgan, a resident of the Washington, DC, area living with multiple sclerosis, has been on disability since her employer denied her request to work part-time from home before the Covid pandemic. She expressed skepticism about her ability to meet the 80-hour work requirement to remain on Medicaid.
“There are a number of us out here that still want to work,” Morgan states, emphasizing that numerous individuals like her are eager to contribute to the workforce if given the opportunity. However, the systemic barriers they face are daunting. “My former employer’s blanket refusal meant I had to give up everything,” she laments, describing the loss of her home and car due to the lack of reasonable accommodations.
The Trump administration’s efforts against workplace accommodations have been relentless. They have targeted programs designed to include disabled workers, weakened worker protections, and rolled back regulations aimed at alleviating subminimum wage practices. Ironically, while the administration claims to push disabled Americans into the workforce, it simultaneously envisions Medicaid recipients filling gaps left by deported agricultural workers.
The ongoing surge of Covid-19 cases only exacerbates the difficulties faced by immunocompromised individuals in finding safe employment. Jill Zegers, living in Nebraska with chronic inflammatory demyelinating polyneuropathy, an autoimmune disorder that necessitates immunosuppressant medication, has struggled to find suitable work since 2017.
“All of my work history is public-facing,” Zegers explains. “So I’ve tried to get jobs that I could do from home. It’s not happening.” Despite her previous remission, she continues to experience nerve damage in her hands, and the prospect of losing Medicaid due to an inability to meet the work requirement is frightening.
“If I fall out of remission, I literally can’t walk, and it’s possible I could lose most function in my hands,” Zegers shares, underscoring the precariousness of her situation.
Zegers has encountered similar obstacles while applying for Social Security disability benefits—having submitted her application three times thus far. Her experiences highlight the broader implications of the impending Medicaid work requirements. “I’ve talked to people from the government,” she recounts, “and they ask all those questions like, ‘Oh, can you stand for two hours?’” For many chronically ill individuals, the answer may be “yes” on a good day, but that does not reflect their everyday reality. Such assessments could easily disqualify applicants as the Biden administration’s HHS aims to trim Medicaid enrollment.
For Dai, the prospect of Medicaid cuts to finance tax breaks for the wealthy is “ridiculous and cruel and deceitful.” He argues that it effectively shifts essential public health funds “straight into billionaires’ pockets”—a group that includes some of the most vocal advocates for a return to in-office work.
As the struggle for disabled workers continues, it becomes increasingly clear that the fight for equitable job opportunities and comprehensive healthcare is far from over. The potential loss of Medicaid and the challenges presented by new work requirements reflect a troubling trend that prioritizes the interests of the wealthy over the rights and needs of society’s most vulnerable.
