- Trump Poised to Take Action on Medicaid Work Requirements The Hill by Peter Sullivan — The Trump administration is preparing to release guidelines soon for requiring Medicaid beneficiaries to work, according to sources familiar with the plans, a major shift in the 50-year-old program. The guidelines will set the conditions for allowing states to add work requirements to their Medicaid programs for the first time, putting a conservative twist on the health insurance program for the poor. Democrats are gearing up for a fight, likely including lawsuits, arguing the administration is trying to undermine Obamacare's Medicaid expansion on its own after Congress failed to repeal the health care law.