CMS Administrator Dr. Mehmet Oz said Tuesday the Trump administration will require able-bodied Medicaid recipients to work, volunteer or pursue an education for 20 hours a week to keep free coverage. He cast the overhaul as a reset of the program’s purpose and said it would push the safety net back toward what he called its 1965 intent.
The announcement came at a White House news briefing on Tuesday afternoon, June 2, 2026, as the administration widened its campaign against what it calls waste and abuse in federal healthcare spending. Oz said the new rule is meant to reach millions of people on Medicaid who are able-bodied but not working, and he framed the change as part of a broader effort to tighten eligibility and spending at the same time.
Oz said the administration has identified roughly $2 billion in federal tax dollars that he said were improperly going to illegal immigrants, a figure he said has doubled since he first raised the issue last year. He also said CMS has told California it owes the federal government $2 billion, and that half of that amount has already been recouped. The administration is pressing ahead on both fronts at once: cutting what it describes as improper spending on healthcare for illegal immigrants and rewriting who qualifies for Medicaid help.
The policy shift also puts a sharper edge on the fight over what Medicaid should cover. Oz said California’s Medi-Cal program provided full dental and full vision benefits until this administration, then added that he likes those benefits but does not think the federal government should pay for coverage that goes beyond national policy. He said taxpayers in New Mexico and Mississippi help pay for benefits California allows for illegal immigrants, arguing that the system should be made more uniform before Washington keeps footing the bill.
Oz paired that argument with a blunt portrait of Medicaid use among people who are not working. “If you're sitting at home, which is true for the millions of people who are able-bodied on Medicaid, on average, you're spending 6.1 hours watching television just hanging around,” he said. The administration has also warned of $5.4 trillion in additional Medicaid costs over the next decade, a figure that gives the work-rule overhaul immediate budget weight as well as political force. What remains unresolved is how CMS will enforce the 20-hour requirement and when the new rule will actually take effect.
