It’s a notable change after the partisan nature of the debate in recent years: Republicans have long wanted waivers from the mandate, which have been used on and off for the last 20 years, to expire amid fears about prolonged government dependency and fraud. Democrats see the option as economically justified absent a stronger safety net.

Without a waiver, able-bodied adults would have to work at least 20 hours a week or spend the equivalent amount of time in a workforce development program. Until the requirement is met, benefits would be limited to three months over a three-year period.

“This successful shift in welfare policy showed that improving welfare services can be achieved while lowering costs for taxpayers and increasing employment,” Burns said of his House Bill 1807.

The bill, cosigned by Rep. Mark Gillen, a Republican representing a district in Reading, would require able-bodied adults to work or engage with their communities to qualify for Medicaid.

“The intention is to encourage physically and mentally able Medicaid enrollees to find employment, job training, or volunteer opportunities,” Burns said. “Work and community engagement policies such as this have proven to be successful in several states, with reduced costs and decreases in unemployment.”

Welfare expansion has outpaced population growth: Pennsylvania has only gained 700,000 residents since 2000. But the state budget is dominated by this spending that runs through the Department of Human Services.

Medicaid spending has ballooned over the last 25 years. The state spent $10.7 billion on 1.3 million residents in 2000, but now, the commonwealth appropriates $47 billion to provide benefits to 3.3 million residents.

Though human services eat up a significant chunk of all state budgets, the commonwealth stands out: Pennsylvania’s Medicaid expenditures as a percentage of its budget is the highest in the nation, according to an analysis from the Foundation for Government Accountability.

During a 2024 legislative hearing, Adelson called it “fraud by design” when recipients could get in the Medicaid program before the state verified eligibility. Meanwhile, 14,000 people with intellectual and physical disabilities remain on a waiting list for resources.

“That’s how you get this robbery of this safety net,” he said. “If you’re stopping fraud and saving money, it’s to protect these folks and taxpayers.”

For critics of work requirements, it’s not that simple.

In an analysis from the Urban Institute, able-bodied adults are considered a “challenging” group to serve. These beneficiaries are more likely to be homeless or live with a mental or physical condition that doesn’t qualify as a disability, even though it makes working unrealistic.

The research also showed that income decreases for residents who only receive benefits for three months, suggesting that time limits do not encourage employment.

Burns has a second proposal, House Bill 1808, that wants to try extended limits for transitioning off benefits in a different program – Temporary Assistance for Needy Families.

The cash benefits would be reformed through a Clinton-inspired “Welfare to Work” pilot program, in which recipients will increase employment hours as benefits taper off.

The pilot would launch in counties with populations between 90,000 and 209,999, where recipients working 20 hours would receive full benefits for six months.

“This program will encourage companies to hire individuals enrolled on the welfare rolls, helping families to transition to self-sufficiency by providing an incentive to work,” Burns said in the proposal’s cosponsorship memo. “In doing so, businesses will be able to tap into this potential pool of workers.”

Democratic Reps. Manuel Guzman and Jim Haddock, as well as Republican Rep. Andrew Kuzma have co-sponsored the bill.

Both await consideration in the House Human Services Committee.

Anthony Hennen contributed to this report.