House Speaker Mike Johnson says Medicaid work requirements in Trump's "big, beautiful bill" have a "moral component"

CBS News

25-05-2025

House Speaker Mike Johnson, who shepherded President Trump's "one big, beautiful bill" through Congress, said Sunday that the Medicaid work requirements — which could affect his home state of Louisiana — have a "moral component" to them because people on Medicaid who "refuse" to work are "defrauding the system."
"If you are able to work and you refuse to do so, you are defrauding the system," Johnson said Sunday on "Face the Nation with Margaret Brennan." "You're cheating the system. And no one in the country believes that that's right. So there's a moral component to what we're doing. And when you make young men work, it's good for them, it's good for their dignity, it's good for their self-worth, and it's good for the community that they live in."
The GOP-controlled House passed the massive bill, which sets priorities for Mr. Trump's agenda for upcoming budgets, by just one vote in the early hours Thursday after an all-night session. The bill is now headed to the Senate, where several Republicans have already voiced concerns, including Sens. Josh Hawley and Rand Paul.
The bill went through intense debate in two committees last week as an alliance of blue-state Republicans and fiscal hawks refused to budge. Given Republicans' razor-thin majority in the House, Mr. Trump went to the Hill on Tuesday to rally the holdouts in the GOP conference.
To pay for some of Mr. Trump's tax reforms, such as extending his 2017 tax cuts and eliminating tax on tips, there are cuts to several programs. Republicans have insisted they are not cutting Medicaid, and reductions in the low-income entitlement program have become one of the most charged parts of the bill. In a closed-door session Tuesday with members of the Republican conference, sources in the room told CBS News Mr. Trump said, "Don't f*** around with Medicaid."
To save money on Medicaid, the final version of the bill puts work requirements on Medicaid, which Johnson has insisted will account for the bulk of any cost-cutting. An analysis by the healthcare nonprofit KFF found that 190,000 people in Louisiana, Johnson's home state, stand to lose Medicaid under new requirements.
Johnson insisted on Sunday that "we have not cut Medicaid, and we have not cut SNAP," the food stamp program.
"What we're doing … is working on fraud, waste and abuse, and everyone in Louisiana and around the country understands that that's a responsibility of Congress," Johnson said.
He said there are 4.8 million Americans on Medicaid who are "able-bodied workers, young men, for example, who are not working, who are taking advantage of the system." Calling it a "moral component" to put Americans to work, he added, "when you make young men work, it's good for them, it's good for their dignity, it's good for their self-worth, and it's good for the community that they live in."
Johnson also claimed some of those who are on Medicaid and SNAP are undocumented immigrants, although they are not eligible to receive food stamps or Medicaid.
When moderator Margaret Brennan pushed back for Johnson to clarify that his position is that the estimated 190,000 Louisianans who stand to lose Medicaid coverage are "lazy, not working? That they were undocumented? What about them? How do you defend that they will be losing their benefits?"
"No. What we're talking about, again, is able-bodied workers, many of whom are refusing to work because they're gaming the system," Johnson said. "And when we make them work, it'll be better for everybody, a win-win-win for all."
Johnson said the Medicaid work requirements are "not some onerous, burdensome thing," saying they require recipients to work a minimum of 20 hours a week — either working, be in job training programs or volunteering in the community.
"When the American people understand what we are doing here, they applaud it," Johnson said. "This is a wildly popular thing, because we have to preserve the programs. What we're doing is strengthening Medicaid and SNAP so that they can exist, so that they'll be there for the people that desperately need it the most, and it's not being taken advantage of. And this is something that everybody in Congress, Republicans and Democrats, should agree to."
But as the bill heads to the Senate for debate, the GOP's Hawley has called it "both morally wrong and politically suicidal" to slash Medicaid, indicating brewing opposition to it in that chamber.
Hawley particularly took issue with a cost-sharing measure with Medicaid between federal and state governments, which he said would force those at or just over the federal poverty level to pay as much as $35 for a medical visit. Johnson pushed back on that claim, saying that the House included in the bill a "modest state-sharing component, so that they'll pay attention to that, so that we can reduce fraud."
But as Brennan noted, the bill still has to pass the Senate, and if Senators make the expected changes to the bill, it will have to go back to the House. Johnson said he had lunch with his Republican counterparts in the upper chamber on Tuesday, and he said he reminded them that they are a team.
"It's the Senate and the House Republicans together that will deliver this ball over the goal line, so to speak," Johnson said. "And I encouraged them to make as few modifications as possible, remembering that I have a very delicate balance on our very diverse Republican caucus over in the House."