The Myth of the “Able-Bodied”: Why Medicaid Cuts Hurt Working Americans

In today's polarized political environment, few terms are as misunderstood—and misused—as "able-bodied." In the debate over Medicaid cuts, this phrase has become a catch-all for people assumed to be freeloading on the system, healthy enough to work and therefore undeserving of government-supported healthcare. It's a dangerous misclassification, one that grossly distorts the realities of modern working-class life and undermines the very purpose of Medicaid.

Let's be clear: many of those categorized as "able-bodied" adults on Medicaid are- in fact, working. According to the Kaiser Family Foundation, nearly 6 in 10 non-elderly Medicaid enrollees are employed either full- or part-time.

They are not gaming the system; they are part of it. They clean our hospitals, stock our grocery shelves, service landscaping, deliver packages and food to doorsteps, serve in restaurants, care for our children, and drive our buses. And despite their labor, they remain economically fragile and medically vulnerable.

Take the widely touted $20/hour wage—equivalent to roughly $41,600 annually. That may sound adequate on paper, but after taxes, health insurance premiums, and payroll deductions, a worker is left with closer to $30,000. In most American cities, this is not enough to cover the cost of rent, food, transportation, child care, utilities, and, increasingly, out-of-pocket medical expenses. According to the Economic Policy Institute, a family of four in the Chicago metro area, for example, needs over $80,000 annually to meet basic needs.

A single unexpected medical bill can be devastating for workers facing this kind of economic squeeze. A 2025 Bankrate survey found that 39% of Americans couldn't cover a $1,000 emergency with savings. And yet, healthcare expenses are the leading cause of personal bankruptcy in the U.S.

I experienced this reality firsthand. Recently, I fell from a tree while helping neighbors clear fallen trees after a storm. Though I recovered physically, the financial toll was significant. Despite having full-time employment and high-premium health insurance, I received over $1,000 in hospital bills for ER visits, diagnostic tests, and follow-ups with my primary care physician.

The working poor often hold multiple jobs. That means 50–60 hour workweeks with little time for healthy meal preparation, exercise, leisure, or sleep. Chronic time scarcity and physical exhaustion contribute to rising rates of hypertension, diabetes, depression, and anxiety among low-income workers. Despite financial insecurity, the working poor contribute to state and federal tax revenue through payroll, income, and sales taxes. Their labor supports essential industries, small businesses, and local economies—often without adequate employer-provided benefits.

It's not surprising, then, that this population ages into disability faster than any other group. Moreover, work-related injuries among laborers, drivers, cleaners, and care aides are common yet often poorly compensated or denied altogether. When coupled with underinsurance, these injuries can push individuals out of the workforce entirely, creating a revolving door between work and disability.

Without accessible, preventive healthcare—precisely the kind Medicaid provides—small problems grow into crises. A treatable infection becomes a hospitalization. Undiagnosed hypertension becomes a stroke. Mild depression becomes suicidal ideation.

The working poor are also the prime targets of industries that capitalize on stress and despair. Fast food advertising saturates low-income neighborhoods. Vaping products and high-sugar beverages are aggressively promoted. And now, state-sanctioned cannabis dispensaries increasingly market to communities where hope is in short supply. Though cannabis legalization has public health benefits, it has also brought unintended consequences. Research shows a rise in cannabis-induced psychosis and emergency psychiatric admissions, particularly among young adults in marginalized communities.

Medicaid plays a vital role in funding behavioral health services for such individuals—cuts would mean a surge in untreated mental illness and emergency room overuse. Eliminating Medicaid coverage for "able-bodied" adults under the pretext of cost-saving is shortsighted and self-defeating. It trades short-term budget optics for long-term societal costs: more ER visits, higher rates of disability, unaddressed mental health issues, lost labor productivity, and preventable deaths.

States expanding Medicaid experienced improvements in health outcomes, reduced mortality, and better financial security for low-income residents. Furthermore, Medicaid reduces uncompensated care burdens on hospitals and serves as an economic stabilizer during downturns. However, many working poor go unsheltered for long periods of time, and Medicaid provides some much needed coverage.

Politicians from both sides of the aisle must resist the urge to weaponize rhetoric about the "able-bodied." This language is not only stigmatizing—it is intellectually lazy. It ignores the economic realities of wage stagnation, the medical realities of unrelenting stress, and the public health realities of untreated illness. It ignores the story of the working American in 2025.

Solutions don't lie in blanket cuts but in targeted investments:

• Expand access to primary and preventive care
• Advance community engagement and care coordination for vulnerable populations
• Integrate behavioral health services into Medicaid expansion
• Fund workplace health and injury prevention programs
• Support digital infrastructure and telehealth for shift workers
• Reform state Medicaid eligibility to reflect real-world wages

The phrase "able-bodied" may sound clear-cut, but the lives it seeks to describe are anything but. Working-class Americans are not freeloaders—they are contributors, caregivers, and citizens navigating a punishing economy and a fragmented healthcare system. Medicaid is not charity but the scaffolding of health equity and economic participation.

Whether in a storm-damaged yard, church pew, block party, or corner diner, Americans are asking whether their government understands their challenges. We must meet them with clarity, compassion, and policies grounded in data—not ideology. Medicaid is not the problem. It's part of the solution.

Medicaid is not a handout. It's a public health investment in America's essential workforce. Cuts today mean crises tomorrow.