Weekly insights and analysis on the latest developments in military technology, strategy, and foreign policy.
The Association of the U.S. Army’s (AUSA) annual symposium has seen some notable appearances by autonomous launchers, underscoring the service’s growing interest in this class of system. On show at the event were a new Family of Multi-Mission Autonomous Vehicles (FMAV) from Oshkosh Defense, as well as Raytheon’s DeepFires. Between them, these platforms can be armed with a wide variety of offensive and defensive weapons, including Tomahawk cruise missiles and Patriot surface-to-air missiles.
A promotional image shows the three-strong Family of Multi-Mission Autonomous Vehicles (FMAV) from Oshkosh Defense. Oshkosh
Extreme Multi-Mission Autonomous Vehicle (X-MAV)
The FMAV series from Oshkosh Defense comprises three different truck chassis that can carry a wide variety of weapons. The three vehicles are described as being “production-ready” by the manufacturer and comprise the following:
The largest of the FMAV series, the purpose-built X-MAV is able to support long-range munitions, including a podded launcher with four Tomahawk missiles. The 10×10 wheeled chassis offers off-road mobility, as well as integrated onboard power. Oshkosh is aiming the X-MAV at the U.S. Army’s Common Autonomous Multi-Domain Launcher Heavy (CAML-H) program.
In August, the Army revealed more details of CAML-H, which aims to integrate a launcher onto a 15-ton class chassis that will fire either Tomahawk missiles or the Patriot Advanced Capability 3 Missile Segment Enhancement (PAC-3 MSE) interceptor.
It is also worth noting here that the Army is already fielding the Typhon missile system, which includes tractor-trailer launchers capable of firing Tomahawks and SM-6s. Meanwhile, however, the Army has begun looking at smaller launchers that are easier to deploy as companions to Typhon, something we have reported on in the past.
Medium Multi-Mission Autonomous Vehicle (M-MAV). Oshkosh
“M-MAV delivers advanced navigation, remote operation, and automated resupply capabilities to increase survivability, reduce crew burden, and enable dispersed, resilient fires formations,” Oshkosh said in its press release.
Light Multi-Mission Autonomous Vehicle (L-MAV)
The L-MAV is derived from the U.S. Marine Corps ROGUE-Fires and is a 4×4 autonomous carrier. It uses a modular design, so it can be rapidly configured for missions. These include counter-uncrewed aerial systems (C-UAS), electronic warfare, or resupply, for example. Examples of payloads shown at AUSA were the AeroVironment Switchblade 600 loitering munition and the Titan C-UAS.
“The Army has been clear on the need for autonomous, payload-agnostic platforms that are ready now,” said Pat Williams, chief programs officer at Oshkosh Defense, as he outlined the FMAV series. “The Oshkosh Family of Multi-Mission Autonomous Vehicles is engineered on proven tactical vehicles, with scalable autonomy and payload versatility to deliver what the Army needs today with the flexibility to adapt as the battlefield evolves.”
Raytheon DeepFires
Meanwhile, Raytheon revealed more details of its DeepFires autonomous launcher, which uses the Oshkosh FMTV A2 — the same platform employed by the middle-tier M-MAV. Raytheon has already been using the FMTV A2 platform for its DeepStrike autonomous launcher, which you can read more about here.
Raytheon’s uncrewed launcher vehicle fires a Joint Reduced Range Rocket (JR3) at the Army’s recent Project Convergence-Capstone 5 (PC-C5) test exercise at the National Training Center (NTC) at Fort Irwin, California, earlier this year. The uncrewed launcher vehicle is also a cooperative development with Forterra and Oshkosh Defense. Raytheon
As for DeepFires, this has been designed for modularity, able to pivot very quickly from offensive or defensive fires. The vehicle is also designed for optionally crewed or fully autonomous operations and has already been tested.
Weapons payloads for DeepFires range from the AIM-9X Sidewinder for air defense all the way up to the Tomahawk. Raytheon has been tight-lipped about exactly how many rounds of each type of missile can be loaded on a single vehicle, although a promotional video from the company shows one of the trucks carrying two containerized Tomahawk rounds. Meanwhile, one of the DeepFires vehicles exhibited at AUSA was loaded with four Patriot missiles.
A still from a promotional video shows DeepFires with two containerized Tomahawk cruise missiles. Raytheon screencap
Speaking to media, including TWZ, at AUSA, Brian Burton, vice president, Precision Fires and Maneuver at Raytheon, hinted at the possibility of carrying significant numbers of smaller weapons, like the AIM-9X:
“One of the big things when we got feedback from the warfighters was more magazine depth. Not a surprise. We hear that all the time. So, this is something that we’ve been looking at from the very beginning — how do we increase that? So, it can vary, but you’re looking at a significant increase in magazine depth, and that’s obviously important to whether you’re putting additional fires down range or it’s just defending your area.”
Another key requirement that emerged from Army feedback on DeepFires was onboard vehicle power. Not only does the onboard power allow for the handling, including reloading, of missile rounds, but it also provides additional mobility, since the vehicle is not tied to a separate generator. “That was a key piece that came out of touchpoints with the customer and feedback that we incorporated, and they’re really excited about that,” Burton said.
Raytheon’s DeepFires at the Association of the U.S. Army’s (AUSA) main annual symposium. The vehicle is loaded with a four-round Patriot missile launcher. Howard Altman
Also built into the DeepFires concept, from the outset, is air transportability, including by the C-130 airlifter. “We wanted to put something together that could be very mobile,” Burton explained, “and [to] be able to get on that [C-130] platform gives the warfighters a lot more flexibility as to where they can get to and how quickly they can get there, and how quickly they can get out.”
The air transportability of DeepFires also helps answer broader U.S. military concerns about establishing diverse, distributed logistics chains. These are seen as an essential requirement for supporting future operations in contested environments, especially in the context of a potential future high-end conflict, including in the Pacific.
The relevance of DeepFires to the Indo-Pacific theater is something that was referenced directly by Scott Sanders, chief growth officer at Forterra, the company that provides the autonomous capabilities for the system. “The only thing more terrifying than a fleet of unmanned vehicles hiding in the Indo-PACOM somewhere is probably a B-21,” he said.
Front view of Raytheon’s DeepFires. Howard Altman
At the same time, a system such as this could be highly relevant for contingencies in the European theater, where long-range precision fires are increasingly seen as necessary to offset potential Russian aggression. In the near future, it may also be possible that Ukraine will need a launcher of this kind, should it be approved to receive Tomahawks. Ukraine has some experience in this area, having already been successful with remote Patriot launcher operations.
For autonomous operations, an operator is able to control between one to six DeepFires vehicles, depending on theater requirements. The vehicles can be controlled independently, using a route-following approach. In this mode, they will be given endpoint goals where the firing battery is required, and they will self-navigate from point A to point B.
Alternatively, Raytheon is proposing a “follower technique,” in which the first vehicle is crewed. “You can pick up a string of [uncrewed] vehicles behind you, move really quickly to your firing point, disperse via waypoint-based navigation into your firing points, and regroup,” Burton explained. In terms of command and control, DeepFires is intended to be “relatively comms agnostic,” Burton said, meaning that it can be operated using a variety of different networks and bandwidths, including via satellite link.
When asked whether DeepFires is being pitched directly at the Army’s Common Autonomous Multi-Domain Launcher (CAML) program, Burton said that Raytheon is “100 percent tracking and pursuing the CAML opportunity. They’ve seen this as an opportunity, and they are moving out quickly to get this capability into their hands.”
An Army uncrewed Autonomous Multi-Domain Launcher (AML) fires a rocket during an exercise. U.S. Army
Since DeepFires is designed around scalability, Burton said that the launcher could be optimized for both the Medium and Heavy segments of that program: CAML-M and CAML-H.
“We can scale and, working with Oshkosh and with Forterra, bring that to a larger, heavier vehicle, if that’s what the demand and the means are for the Army,” Burton observed.
Other options for DeepFires could include the possibility of a separate autonomous launcher that would be dedicated to air defense, building upon the planned integration of the AIM-9X and Patriot on the basic platform. “Certainly, we’re looking at both,” Burton said, noting that Raytheon also provides a lot of in-house air defense capabilities, including counter-uncrewed aerial systems (C-UAS). These include the Coyote Block 2, a jet-powered drone-like loitering interceptor that the Army currently fields as part of the mobile and fixed-site versions of its Low, Slow, Unmanned Aircraft Integrated Defeat System (LIDS).
With a growing focus on battlefield survivability in the face of drone proliferation, of the kind that’s been seen in the war in Ukraine, Raytheon says it’s considering C-UAS capabilities that are indigenous to the platform itself, or mounted on a different, dedicated platform.
The appearance of these somewhat-related autonomous launchers at AUSA points again to the U.S. military’s interest in flexible, highly mobile, very hard to target systems that offer significant reach and relevant magazine capacity, and which are optimized for future scenarios in the Indo-Pacific region.
Already, the Army has explored this concept with an uncrewed derivative of the HIMARS launcher vehicle called the Autonomous Multi-domain Launcher (AML).
The Autonomous Multi-domain Launcher (AML) prototype. U.S. Army
Building on the prototype AML, the Army has since put out a contracting notice outlining a potential family of uncrewed launcher vehicles — the aforementioned CAML, which the Oshkosh and Raytheon options may well end up competing for.
Various kinds of autonomous launchers would be particularly relevant in future expeditionary or distributed operations, especially across the broad expanses of the Pacific during a future major conflict with China, or for trying to deter one. This is a reality that is clearly not lost on the various companies presenting systems in this class at AUSA this week.
Our colleagues at Task & Purpose first reported the elimination of carrier landing qualifications from the graduation requirements for the Tactical Air (Strike) aviator training pipeline earlier today. This pipeline currently produces new pilots to fly the Navy’s F/A-18E/F Super Hornet and F-35C fighters, as well as EA-18G Growler electronic warfare aircraft.
An F-35C lands aboard the US Navy’s supercarrier USS Carl Vinson. An F/A-18F Super Hornet is seen in the background. USN
“The final strike carrier landing qualification occurred in March of 2025,” a Navy official told Task & Purpose. “Students in the strike pipeline, those training to fly F/A-18s, F-35s, and EA-18Gs, are no longer required to qualify by landing on a carrier prior to graduation.”
Naval aviators who come out of the Tactical Air pipeline will now conduct their first carrier qualifications when they reach a Fleet Replacement Squadron (FRS). These units provide initial training on the specific type of tactical jet that those individuals have been assigned to fly.
TWZ has reached out to the Navy to find to what degree Field Carrier Landing Practice (FCLP) landings and touch-and-goes on aircraft carriers are still part of the undergraduate Tactical Air training syllabus. FCLPs are conducted at bases on land, but are structured in a way that “simulates, as near as practicable, the conditions encountered during carrier landing operations,” according to the service.
As noted, just eliminating carrier qualifications from the undergraduate training requirements is a fundamental change in how the Navy produces new Naval Aviators to fly tactical jets. The procedures for taking off from and landing on an aircraft carrier bobbing up and down at sea are significantly different from those when operating from an airfield ashore.
“It’s what makes naval aviation unique,” Sterling Gilliam, a retired Navy captain who is now the director of the National Naval Aviation Museum in Pensacola, Florida, told Task & Purpose when asked about the change. “Audacity has kind of defined Naval Aviation, and the uniqueness of carrier operations, specifically fixed wing launches and recoveries, requires a fair amount of skill and practice and professionalism.”
At the same time, the change does not come as a complete surprise. In 2020, the Navy announced that the requirements for a future Undergraduate Jet Training System (UJTS) jet trainer to replace the T-45 would no longer include the need to be able to land on or take off from an aircraft carrier. In the past year or so, service has also moved to cut demands for the forthcoming UJTS aircraft to have features needed to conduct FCLP landings.
“Carrier qualification is more than catching the wire. It is the exposure to the carrier environment and how an individual deals with it,” an experienced U.S. Navy strike fighter pilot told TWZ back in 2020. “The pattern, the communications, the nuance, the stress. The ability to master this is one of our competitive advantages.”
The UJTS requirements still have yet to be firmed up, at least publicly, ahead of the start of a formal competition, which is expected to kick off next year. The Navy has said in the past that the goal is for the first UJTS aircraft to enter service by 2035 and for the T-45 to be completely phased out by 2040.
The removal of carrier qualifications from the Tactical Air pipeline already shows the Navy is not waiting for the arrival of UJTS to make major changes to its naval aviation training requirements. This would seem to make it increasingly less likely that the service will reverse course on the related changes to the UJTS requirements, at least when it comes to what is needed from the aircraft landing-wise, which will have significant ramifications for the upcoming competition.
Just last week, the Sierra Nevada Corporation (SNC) announced its intention to compete for UJTS with a proposal that puts heavy emphasis on still being able to perform FCLP landings and touch-and-goes, as you can read more about in detail here.
A rendering of a pair of SNC Freedom jet trainers, the design the company is now proposing as a successor to the Navy’s T-45. SNC
“You want … your – I call it your lizard brain – to be trained to do the things you are going to do when things go south on you, because the way a [former Air Force pilot] like me lands an airplane is 180 degrees different than a carrier guy,” Derek Hess, Vice President of Strategy at SNC, told TWZ‘s Jamie Hunter on the sidelines of the Tailhook Association’s main annual symposium last week. “I touch down, go to idle. He touches down, slams down, goes to MIL [maximum non-afterburner thrust], and is ready to take off again.”
“This is why FCLPs are so important,” Ray “Fitz” Fitzgerald, Senior Vice President of Strategy and Technology at SNC, also said while speaking alongside Hess. “On that dark, stormy night, and everything’s just going bad, you rely on muscle memory, right? So when you think about muscle memory, as a carrier aviator, you’re on speed, so you’re on the right AOA, so the hook and the gear are the right AOA to trap, and everything hits at the same time. If I’m at a slow AOA, it means my nose is up, which means the hook grabs first and slams you down. You can break a jet like that. If I’m at a fast AOA, the nose is lower, hook is up, you skip across, and you go flying again, which is not good either.”
“So that muscle memory, I mean, it’s what will save lives,” He added.
Boeing, Lockheed Martin (in partnership with Korea Aerospace Industries), and Textron (together with Italy’s Leonardo) are also set to join the competition, but with aircraft based on existing land-based jet trainer designs that were not built for carrier operations, real or simulated.
Renderings of other proposed T-45 replacement designs. Left to right: a navalized version of Boeing’s T-7A Redhawk, the TF-50N from Lockheed Martin and KAI, and Textron and Leonardo’s offering, now branded as the Beechcraft M-346N. Boeing/Lockheed Martin/Textron
More clarity on the Navy’s future vision for training future naval aviators will come when the final UJTS requirements are released. In the meantime, a major watershed moment has already occurred with the end of carrier qualifications as a graduation requirement for future tactical jet pilots.
Update, 3:30 PM Eastern:
A U.S. Navy official has now provided TWZ with the following additional statement:
“Students in the strike pipeline, those training to fly F/A-18s, F-35s, and EA-18Gs, are no longer required to qualify by landing on a carrier prior to graduation. However, future E-2 [Hawkeye airborne early warning and control aircraft] pilots and international military students will complete carrier landing qualifications on a ship in the T-45 while in student training. Field Carrier Landing Practice (FCLP) landings ashore are still required for graduation. The strategic decision of moving carrier qualifications from the training syllabus to their fleet replacement squadrons was driven by increased technological capabilities in the fleet, as well as the need to reduce training pipeline times, enabling the fleet to receive qualified pilots faster. After earning their initial qualifications after graduation, naval aviators in the strike pipeline are required to complete touch-and-goes and carrier landings at sea during their assignment at the Fleet Replacement Squadrons (FRS).”
The airline is currently looking to hire 17,300 people, equivalent to a mid-size town or the seating capacity of 58 Airbus A350 aircraft, across 350 roles, which include pilots, IT professionals, engineers, and cabin crew
Emirates is looking for new flight attendants(Image: Marika Mikusova)
Emirates Airlines is hiring new flight attendants, but applicants must meet strict criteria.
The airline is currently looking to hire 17,300 people, equivalent to a mid-size town or the seating capacity of 58 Airbus A350 aircraft, across 350 roles. Emirates hasn’t said how many of those job openings are for flight attendants, but it is likely to be within the hundreds, if not thousands.
Flight attendant Marika Mikusova has offered some insight into the Emirates application process(Image: Marika Mikusova)
Emirates has said that new recruits are required for some roles, including cabin crew, pilots, engineers, commercial and sales teams, customer service, ground handling, catering, IT, HR, and finance. Separately, Dnata is looking to hire more than 4,000 cargo, catering, and ground handling specialists.
Some of the benefits included with Emirates jobs are profit share eligibility, comprehensive medical and life insurance cover, travel benefits including flight tickets and membership cards that provide discounts at hundreds of retail, hospitality, and lifestyle outlets.
Although the airline has not advertised wages as part of this recruitment drive, Aviation A2Z reports that the average annual salary of an Emirates flight attendant working in the United States at approximately $47,000 (£34,000) as of last year.
While the salary and benefits appeal, Emirates is particular when it comes to what it is looking for in new recruits. They must be:
Be fluent in both written and spoken English (additional languages are an advantage)
A natural team player with a personality that shines
At least 160 cm tall (5’2”)
Able to reach 212 cm high
Able to meet the UAE’s employment visa requirements
Have at least one year of hospitality/customer service experience (desirable)
Have a minimum of high school (grade 12) education
Have no visible tattoos while in Emirates cabin crew uniform
“Irrespective of nationality, Emirates look for a positive attitude, confidence, flexibility, maturity, a friendly disposition and a genuine passion to help others to provide quality service. As the job can be physically demanding, it is imperative you demonstrate resilience and a determination to continually perform well”, the job requirements add.
Marika Mikusova, a flight attendant with Emirates, shared her recollection of the application process. “For example, I would definitely advise against wearing unnatural hair or nail colour! I personally attended open days twice. The first time I didn’t even pass the first round of the interview. I assume it was because of what I was wearing,” she explained.
Marika also had some, perhaps slightly more traditional advice for those angling for a job with Emirates. “So I would advise women to put on blazer and pencil skirt and style their hair in a bun. I would highly recommend putting a lipstick and heels on!”
For men, Marika suggested that they arrive clean-shaven or with a moustache only, and dressing in a suit.
“Mind your body language! Put on a gentle smile and present yourself in a calm manner. Do not cross your arms during interview as you would look unapproachable or even angry,” she added.
Marika even recalled a time when she attended her Prague Emirates Open Day, where several Korean women hoping to become flight attendants had flown in from other continents just to attend the Emirates Open Day.
“In fact, the interview was conducted entirely in English and was not limited by the nationalities of the candidates, the number of participants, or how many times each candidate attended Open Days in the past. So you can try multiple interviews outside your country,” Marika concluded.
Those aspiring to join the Emirates Group can apply for the various roles and keep a lookout for open days and recruitment events worldwide at www.emiratesgroupcareers.com.
The nation’s first mandated work requirement for Medicaid recepients, approved by the Republican-led Congress and signed by President Trump, is expected to have a seismic effect in California.
One estimate from state health officials suggests that as many as 3.4 million people could lose their insurance through what Gov. Gavin Newsom calls the “labyrinth of manual verification,” which involves Medi-Cal recipients proving every six months that they are working, going to school or volunteering at least 80 hours per month.
“It’s going to be much harder to stay insured,” said Martha Santana-Chin, the head of L.A. Care Health Plan, a publicly operated health plan that serves about 2.3 million Medi-Cal patients in Los Angeles County.
She said that as many as 1 million people, or about 20% to 40% of its members, could lose their coverage.
The work requirement will be the first imposed nationwide in the six-decade history of Medicaid, the program that provides free and subsidized health insurance to disabled and low-income Americans.
It’s relatively uncharted territory, and it’s not yet clear how the rules will shake out for the 5.1 million people in California who will be required to prove that they are working in order to qualify for Medi-Cal, the state’s version of Medicaid.
After the 2026 midterm elections, millions of healthy adults will be required to prove every six months that they meet the work requirement in order to qualify for Medicaid. The new mandate spells out some exceptions, including for people who are pregnant, in addiction treatment or caring for children under age 14.
Democrats have long argued that work requirements generally lead to eligible people l osing their health insurance due to bureaucratic hurdles. Republicans say that a work requirement will encourage healthy people to get jobs and preserve Medicaid for those who truly need it.
“If you clean that up and shore it up, you save a lot of money,” said House Speaker Mike Johnson of Louisiana. “And you return the dignity of work to young men who need to be out working instead of playing video games all day.”
Only three U.S. states have tried to implement work requirements for Medicaid recipients: New Hampshire, Arkansas and Georgia. One study found that in the first three months of the Arkansas program, more than 18,000 people lost health coverage.
People can lose coverage a variety of ways, said Joan Alker, a Georgetown University professor who studies Medicaid. Some people hear that the rules have changed and assume they are no longer eligible. Others struggle to prove their eligibility because their income fluctuates, they are paid in cash or their jobs don’t keep good payroll records. Some have problems with the technology or forms, she said, and others don’t appeal their rejections.
Of the 15 million people on Medi-Cal in California, about one-third will be required to prove they are working, the state said. Those people earn very little: less than $21,000 for a single person and less than $43,000 for a household of four.
The state’s estimate of 3.4 million people losing coverage is a projection based on what happened in Arkansas and New Hampshire.
But those programs were brief, overturned by the courts and weren’t “a coordinated effort among the states to figure out what the best practices are,” said Ryan Long, the director of congressional relations at the Paragon Health Institute, a conservative think tank that has become influential among congressional Republicans.
Long said advancements in technology and a national emphasis on work requirements should make work verification less of a barrier. The budget bill includes $200 million in grants for states to update their systems to prepare, he said.
Arguments from liberal groups that people will lose healthcare are a “straw man argument,” Long said: “They know that the public supports work requirements for these benefits, so they can’t come out and say, ‘We don’t support them.’”
A poll by the health research group KFF found this year that 62% of American adults support tying Medicaid eligibility to work requirements.
The poll also found that support for the policy drops to less than 1 in 3 people when respondents hear “that most people on Medicaid are already working and many would risk losing coverage because of the burden of proving eligibility through paperwork.”
In June, Newsom warned that some Californians could be forced to fill out 36 pages of paperwork to keep their insurance, showing reporters an image of a stack of forms with teal and gold accents that he described as “an actual PDF example of the paperwork that people will have to submit to for their eligibility checks.”
Many Californians already are required to fill out that 36-page form or its online equivalent to enroll in Medi-Cal and Covered California, the state’s health insurance marketplace.
Experts say it’s too soon to say what system will be used for people to prove their work eligibility, because federal guidance won’t be finalized for months.
Newsom’s office directed questions to the Department of Health Care Services, which runs Medi-Cal. A spokesperson there said officials are “still reviewing the full operational impacts” of the work requirements.
“The idea that you are going to get a paper submission every six months, I’m not sure people have to do that,” Long said.
Georgia is the only state that has implemented a lasting work requirement for Medicaid. Two years ago, the state made healthcare available to people who were working at least 80 hours per month and earned less than the federal poverty limit (about $15,000 for one person or $31,200 for a household of four).
More than 100,000 people have applied for coverage since the program’s launch in July of 2023. As of June of this year, more than 8,000 people were enrolled, according to the state’s most recent data.
The Medicaid program has cost more than $100 million so far, and of that, $26 million was spent on health benefits and more than $20 million was allocated to marketing contracts, KFF Health News reported. Democrats in Georgia have sought an investigation into the program.
The Inland Empire agency that provides Medi-Cal coverage for about 1.5 million people in San Bernardino and Riverside counties estimated that 150,000 members could lose their insurance as a result of work requirements.
Jarrod McNaughton, the chief executive of the Inland Empire Health Plan, said that California’s 58 counties, which administer Medi-Cal, “will be the ones at the precipice of piecing this together” but haven’t yet received guidance on how the eligibility process will be set up or what information people will have to provide.
Will it be done online? Will recipients be required to fill out a piece of paper that needs to be mailed in or dropped off? “We don’t really know the process yet, because all of this is so new,” Naughton said.
In the meantime, he said, the health plan’s foundation is working to make this “as least burdensome as possible,” working to improve community outreach and connect people who receive Medi-Cal insurance to volunteer opportunities.
It took Crystal Strickland years to qualify for Medicaid, which she needs for a heart condition.
Strickland, who’s unable to work due to her condition, chafed when she learned that the U.S. House has passed a bill that would impose a work requirement for many able-bodied people to get health insurance coverage through the low-cost, government-run plan for lower-income people.
“What sense does that make?” she asked. “What about the people who can’t work but can’t afford a doctor?”
The measure is part of the version of President Trump’s “Big Beautiful” bill that cleared the House last month and is now up for consideration in the Senate. Trump is seeking to have it passed by July 4.
The bill as it stands would cut taxes and government spending — and also upend portions of the nation’s social safety net.
For proponents, the ideas behind the work requirement are simple: Crack down on fraud and stand on the principle that taxpayer-provided health coverage isn’t for those who can work but aren’t. The measure includes exceptions for those who are under 19 or over 64, those with disabilities, pregnant women, main caregivers for young children, people recently released from prisons or jails — or during certain emergencies. It would apply only to adults who receive Medicaid through expansions that 40 states chose to undertake as part of the 2010 health insurance overhaul.
Many details of how the changes would work would be developed later, leaving several unknowns and causing anxiety among recipients who worry that their illnesses might not be enough to exempt them.
Advocates and sick and disabled enrollees worry — based largely on their past experience — that even those who might be exempted from work requirements under the law could still lose benefits because of increased or hard-to-meet paperwork mandates.
Benefits can be difficult to navigate even without a work requirement
Strickland, a 44-year-old former server, cook and construction worker who lives in Fairmont, North Carolina, said she could not afford to go to a doctor for years because she wasn’t able to work. She finally received a letter this month saying she would receive Medicaid coverage, she said.
“It’s already kind of tough to get on Medicaid,” said Strickland, who has lived in a tent and times and subsisted on nonperishable food thrown out by stores. “If they make it harder to get on, they’re not going to be helping.”
Steve Furman is concerned that his 43-year-old son, who has autism, could lose coverage.
The bill the House adopted would require Medicaid enrollees to show that they work, volunteer or go to school at least 80 hours a month to continue to qualify.
A disability exception would likely apply to Furman’s son, who previously worked in an eyeglasses plant in Illinois for 15 years despite behavioral issues that may have gotten him fired elsewhere.
Furman said government bureaucracies are already impossible for his son to navigate, even with help.
It took him a year to help get his son onto Arizona’s Medicaid system when they moved to Scottsdale in 2022, and it took time to set up food benefits. But he and his wife, who are retired, say they don’t have the means to support his son fully.
“Should I expect the government to take care of him?” he asked. “I don’t know, but I do expect them to have humanity.”
There’s broad reliance on Medicaid for health coverage
About 71 million adults are enrolled in Medicaid now. And most of them — around 92% — are working, caregiving, attending school or disabled. Earlier estimates of the budget bill from the Congressional Budget Office found that about 5 million people stand to lose coverage.
A KFF tracking poll conducted in May found that the enrollees come from across the political spectrum. About one-fourth are Republicans; roughly one-third are Democrats.
The poll found that about 7 in 10 adults are worried that federal spending reductions on Medicaid will lead to more uninsured people and would strain health care providers in their area. About half said they were worried reductions would hurt the ability of them or their family to get and pay for health care.
Amaya Diana, an analyst at KFF, points to work requirements launched in Arkansas and Georgia as keeping people off Medicaid without increasing employment.
Amber Bellazaire, a policy analyst at the Michigan League for Public Policy, said the process to verify that Medicaid enrollees meet the work requirements could be a key reason people would be denied or lose eligibility.
“Massive coverage losses just due to an administrative burden rather than ineligibility is a significant concern,” she said.
One KFF poll respondent, Virginia Bell, a retiree in Starkville, Mississippi, said she’s seen sick family members struggle to get onto Medicaid, including one who died recently without coverage.
She said she doesn’t mind a work requirement for those who are able — but worries about how that would be sorted out. “It’s kind of hard to determine who needs it and who doesn’t need it,” she said.
Some people don’t if they might lose coverage with a work requirement
Lexy Mealing, 54 of Westbury, New York, who was first diagnosed with breast cancer in 2021 and underwent a double mastectomy and reconstruction surgeries, said she fears she may lose the medical benefits she has come to rely on, though people with “serious or complex” medical conditions could be granted exceptions.
She now works about 15 hours a week in “gig” jobs but isn’t sure she can work more as she deals with the physical and mental toll of the cancer.
Mealing, who used to work as a medical receptionist in a pediatric neurosurgeon’s office before her diagnosis and now volunteers for the American Cancer Society, went on Medicaid after going on short-term disability.
“I can’t even imagine going through treatments right now and surgeries and the uncertainty of just not being able to work and not have health insurance,” she said.
Felix White, who has Type I diabetes, first qualified for Medicaid after losing his job as a computer programmer several years ago.
The Oreland, Pennsylvania, man has been looking for a job, but finds that at 61, it’s hard to land one.
Medicaid, meanwhile, pays for a continuous glucose monitor and insulin and funded foot surgeries last year, including one that kept him in the hospital for 12 days.
“There’s no way I could have afforded that,” he said. “I would have lost my foot and probably died.”
Mulvihill writes for the Associated Press. AP writer Susan Haigh in Hartford, Conn., contributed to this report.