Congressional Republicans claim to have achieved something truly miraculous. Their One Big Beautiful Bill Act, they argue, would cut nearly $800 billion from Medicaid spending over 10 years without causing any Americans to lose health care—or, at least, without making anyone who loses health care worse off.

The Congressional Budget Office estimates that, by imposing Medicaid work requirements, the bill would eventually increase the uninsured population by at least 8.6 million. At first, Republican officials tried to defend this outcome on the grounds that it would affect only lazy people who refuse to work. This is clearly untrue, however. As voluminous research literature shows, work requirements achieve savings by implementing burdensome paperwork obligations that mostly take Medicaid f

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