This one is blink-and-you’ll-miss-it. He’s arguing for tying Medicaid benefits to work requirements, especially for able-bodied people, and likens Medicaid to a “welfare program.”

The ability to apply premiums and cost-sharing to higher-income enrollees suggests that some beneficiaries might face additional financial responsibilities based on their income, which can further complicate access to care.

Implementing targeted time limits or lifetime caps on benefits aims to prevent long-term dependence on Medicaid. This could mean that beneficiaries might only be eligible for coverage for a certain period, incentivizing them to find work or transition off Medicaid.

Full contextual analysis of Section 3.5: Department of Health and Human Services here.