Medicaid work requirements are policies that condition continued health coverage on a person’s ability to meet certain “community engagement” activities—such as employment, education, or volunteering—and regularly report those activities. Supporters of these policies argue they incentivize work, reduce reliance on government assistance, and promote health and independence through greater self-sufficiency. These arguments often rest on a flawed assumption: that large numbers of Medicaid recipients are not working by choice. In reality, most enrollees are already employed, would qualify for an exemption, or face significant barriers to work, such as chronic illness, caregiving responsibilities, or unstable living conditions.