This is part 5 of a deep dive into Project 2025 and its potential implications for our country should an incoming conservative Republican administration implement its designs for government. You can find the first post in the series by clicking here: What is Project 2025? And why should you care?
POLICY – Eliminating the Federal Role in Disaster Relief
Some of the goals stated in Piller #1 of the Project are reducing federal spending and shifting responsibilities to state and local governments. This could include reducing the federal involvement in disaster recovery efforts and/or transferring those responsibilities to state-level agencies or even the private sector.
Conservatives would see this as an opportunity to cut costs and reduce the federal role in local matters. This is consistent with a theme that runs throughout Project 2025: encouraging a general move toward a smaller government and reducing the amount of money the federal government spends. That almost necessarily means less spending on things like disaster recovery assistance.
There are some counterpoints to offer against this rationale.
- #1, While reducing federal involvement in disaster recovery might appear to be an attractive proposition (reduce costs, shift the burden to the local level), the reality of disasters often requires resources and coordination that exceed the capacities of individual states or localities. How many state and local agencies are really equipped to handle the full brunt of the work that comes with catastrophic disasters? Like it or not, federal disaster management and assistance, through agencies like FEMA, provides critical logistical support, funding, and expertise that states are likely unable to replicate.
- #2. Hurricanes, wildfires, and other large-scale events typically cross state lines and can impact multiple regions simultaneously, necessitating a coordinated federal response. For example, Hurricane Helene caused catastrophic damage as a hurricane and then weakened into a powerful tropical storm, destroying whole cities in North Carolina and Eastern Tennessee.
- #3, There’s the inescapable fact that not every part of the country has the same resources to deal with these things. Wealthier states and regions might be able to fund their own disaster recovery efforts, but poorer and more vulnerable areas could struggle to meet the needs of their citizens without federal support.
- #4. Privatizing disaster recovery would likely increase costs for private citizens, who would have to pay for services that federal funds previously covered. This would create disparities in recovery ability, times, and overall outcomes across the country.
Some of this may sound cool in theory, but it is less cool in reality. Federally managed disaster aid ensures that all citizens, regardless of their state’s financial situation, have equal access to swift and comprehensive recovery efforts, especially when time-sensitive coordination and resources are critical. If this gets shifted to state/local levels or even to the private sector, it likely won’t turn out as great as people would like to think.
POLICY: Imposing New Work Requirements on Medicaid Recipients
This one is specifically called for in Project 2025 – the new implementation of work requirements for Medicaid recipients.
This proposal of work requirements aligns with the broader conservative goals of reducing dependency on government assistance and promoting self-sufficiency among able-bodied adults. From a practical standpoint, by imposing a work requirement, the Project aims to limit Medicaid coverage to only those individuals who are either working, actively seeking employment, participating in job training programs, or meeting certain exemptions, such as caring for dependents or having a disability.
The Current Situation of Medicaid Work Requirements
As of now, Medicaid generally does not impose work requirements on recipients. Medicaid is a federal and state program that provides health coverage to low-income individuals, children, pregnant women, elderly adults, and people with disabilities. Eligibility is mostly based on income, although some categories, like disability, have additional criteria.
Work requirements in Medicaid were briefly introduced under the Trump administration. Some states, like Arkansas and Kentucky, implemented work requirements in 2018, which were either struck down in court or reversed after a short period. The courts found that work requirements violated the primary goal of Medicaid—to provide health coverage, not to enforce employment. Additionally, work requirements often resulted in coverage losses because of administrative difficulties in reporting compliance. It always warms one’s heart to know that they lost their insurance coverage because someone else failed to dot an ‘i’ on the right form.
What Project 2025’s Proposes for Medicaid
The proposal under Project 2025 would likely involve reintroducing and expanding work requirements for Medicaid recipients. While specific details of what these requirements would look like aren’t fully fleshed out in ‘Mandate for Leadership,’ it’s inferred that they would align with broader conservative goals of reducing government spending on social programs by encouraging self-reliance. This could mean that non-disabled, non-elderly Medicaid recipients would need to prove that they are working, looking for work, or participating in job training or community service for a set number of hours per week to remain eligible.
This could look similar to the Temporary Assistance for Needy Families (TANF) program requirements, where recipients must engage in work-related activities for a minimum number of hours to maintain their benefits. The specific hours and qualifying activities could vary by state, as Medicaid is jointly funded by the federal and state governments, allowing states some flexibility.
A Way to Undermine the Affordable Care Act (ACA)?
There is some concern that this kind of proposal could undermine the Affordable Care Act (ACA). The ACA mandates that most Americans have health insurance, and for many low-income individuals, Medicaid expansion has been a critical way to meet this requirement. By adding work requirements to get Medicaid coverage, the proposal could disqualify a significant number of individuals who might not meet the requirements or who face difficulties in documenting compliance. This could result in the loss of Medicaid coverage. From a practical standpoint, because many low-income workers are employed in unstable or part-time jobs that do not provide health insurance, the work requirement could create a gap in coverage for people who cannot afford insurance through the ACA marketplaces and no longer qualify for Medicaid.
Potential Legal Battles
As mentioned earlier, several states attempted to impose work requirements on Medicaid recipients during the Trump administration. Arkansas and Kentucky were at the forefront of these efforts.
Legal battles ensued, largely centered on whether these work requirements aligned with Medicaid’s statutory purpose. Medicaid’s core objective, as established by Congress, is to provide health care to low-income individuals. The argument in the courts was that requiring employment or other work-related activities as a condition for Medicaid eligibility violated this purpose by making it harder for individuals to access care.
In 2019, U.S. District Judge James E. Boasberg ruled against the work requirements in cases involving Kentucky and Arkansas, stating that the Department of Health and Human Services (HHS) had not adequately considered these requirements’ impact on Medicaid beneficiaries. In Arkansas alone, thousands lost coverage due to difficulties complying with the reporting requirements. The court concluded that HHS’s approval of work requirements was “arbitrary and capricious” because it failed to account for the loss of health care coverage, a primary goal of the Medicaid program. These rulings effectively halted the implementation of Medicaid work requirements in several states.
Would the same thing happen if a new Trump Administration tried to revive this? It’s hard to say, but we can be sure that the legal minds in Project 2025 already know all about the court battles and have legal briefs waiting in their back pockets to try to head off future challenges.
Why Mandates for Federal Agencies Matter
We’ll wrap all this up by touching on something that will come up repeatedly when we consider many of these other transformative suggestions or proposals that would aim to change large parts of the government’s operation.
We could summarize this as “Which of these ideas can actually become reality, given the statutory mandates already in place that govern these areas?”
To get a brief idea of what we mean, go back to the legal arguments above with Kentucky and Arkansas. Medicaid’s defenders used the existing Congressional mandate (the purpose) given for the Medicaid program to argue that making Medicaid put work requirements in place caused it to violate the mandate Congress had already given it.
Federal agencies like the Department of Health & Human Services or the EPA are created by Congress and have a “statutory mandate” defining their purpose and scope of work. These federal agencies are tasked with implementing and enforcing laws passed by Congress, and each agency is governed by its statutory mandate in doing any of this. This statutory purpose is the legal framework guiding the agency’s decisions and actions. They’re not supposed to be able to do anything that unduly contradicts or violates the mandate they were given.
For example, the Environmental Protection Agency (EPA) is mandated to protect human health and the environment, while the Centers for Medicare & Medicaid Services (CMS) oversees healthcare programs like Medicaid. When an agency proposes a new rule or policy, it must align with the statutory purpose defined by Congress. If a rule or action contradicts this mandate, it may be challenged in court as a violation of statutory authority. Such challenges often focus on whether the agency’s decision appropriately fulfills Congress’s goals outlined in the legislation that created the agency or program.
In the case of Medicaid work requirements back in 2017-2018, the legal challenges arose because Medicaid’s statutory purpose, established by Congress in the Social Security Act, is to provide healthcare to low-income individuals. Critics of the work requirements argued that these requirements undermined this statutory mandate by imposing additional barriers to healthcare access, particularly for vulnerable populations. In multiple cases, courts have all ruled that the Department of Health and Human Services (which obeyed the mandate from President Trump) failed to demonstrate how work requirements furthered Medicaid’s purpose of providing healthcare coverage.
A Hypothetical Example
This whole thing about mandates and the Court’s comment about work requirements versus Medicaid purpose may be helpful to understand in light of the probability of legal challenges in the future if Trump gets reelected. Let’s take a hypothetical where Congress created a government agency and gave the agency the mandate of, say, working to make sure as many people as possible have access to high-speed internet. So, one of the things the hypothetical agency does is create a program where people in economically depressed or poor areas get subsidized high-speed internet. Let’s then say that the president gets the idea that people without kids don’t need high-speed internet as much because they have less need to watch Bluey on their iPads and gives an order to the agency that they have to survey everyone they come into contact with, asking them if they have children. The directive says that the agency will deny them those benefits if they don’t have children.
Now, admittedly, this hypothetical would probably break down because of some legal issues that better lawyers than I could readily point out. But for the purposes of this specific discussion, one of the things that would happen would be that the courts would say the president’s directive requiring the agency to deny services to people without children isn’t allowed because it puts the agency in the contradictory position of having to disobey or contravene it’s very purpose for existing, which Congress already defined as maximizing the number of people with high-speed internet access. That’s a very off-the-cuff example of what happened with the Medicaid work requirements, and if some of these project 2025 proposals become reality at points in the future, there are going to be a lot of similar contradictory situations that the courts will have to hash out unless they are careful and figure out how to make these a reality without running afoul of agency mandates.
You can bet that if President Trump wins reelection and decides to direct his agencies to implement many of these proposals, the courts will have to work overtime to resolve these issues.
The next installment of the series on Project 2025 will begin looking at Pillar #2, Dismantling the Administrative State.
Image: Pamela Reynoso
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