{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,7]],"date-time":"2026-09-07T14:07:52Z","timestamp":1788790072958,"version":"build-2803163510"},"reference-count":0,"publisher":"Cambridge University Press (CUP)","issue":"2","license":[{"start":{"date-parts":[[2026,9,7]],"date-time":"2026-09-07T00:00:00Z","timestamp":1788739200000},"content-version":"unspecified","delay-in-days":68,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Am. J. Law. Med."],"published-print":{"date-parts":[[2026,7]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:p>Medicaid work requirements were found in 2018 to be contrary to the Medicaid statute because, according to the D.C. Circuit, \u201cthe objective of Medicaid was to furnish medical assistance.\u201d Even though the Secretary of Health and Human Services determined that the work requirements were \u201clikely to assist in improving health outcomes,\u201d the court concluded that \u201cbetter health outcomes as [an] objective of Medicaid \u2026 lacks textual support. Indeed, the statute makes no mention of that objective.\u201d<\/jats:p>\n                  <jats:p>With the second Trump administration making Medicaid work requirements a centerpiece of its budget, the \u201cobjectives of Medicaid\u201d reemerge as both an important statutory constraint on the program and a foundational question for health policy. Though the upcoming debate will likely ride on the efficacy of work requirements, the broad implications of the litigation will inevitably shape broad implications for future Medicaid policy.<\/jats:p>\n                  <jats:p>This article delves into the Medicaid statute to reveal its core objectives, and it makes one legal and one policy claim. First, Medicaid\u2019s statutory language does support the promotion of better health outcomes as one of the program\u2019s objectives, and second, providing services that fall outside \u201cmedical assistance\u201d is critical in improving health outcomes to beneficiaries. As an empirical matter, nonmedical services have become a staple of health care delivery in recent decades, including in some of Medicaid\u2019s signature initiatives, and a careless revisitation of the legality of work requirements undermine some of the program\u2019s most important advances.<\/jats:p>\n                  <jats:p>To address the legality of work requirements, courts should embrace Medicaid\u2019s broader objectives and instead apply one of the statute\u2019s mostly ignored requirements: states must evaluate the efficacy of their innovations. The Medicaid statute encourages states to experiment with new health care delivery strategies to find more affordable and cost-effective strategies to promote population health, including those that rely on nonmedical interventions, but the constraint is not whether those innovations are consistent with Medicaid\u2019s legal objectives but rather whether they are empirically shown to improve population health. And precisely because public health research has identified a wealth of social, behavioral, and nonmedical interventions that have proven to be effective in promoting population health, a proper understanding of the Medicaid statute and the program\u2019s objectives are critical in implementing effective health policy, in the second Trump administration and beyond.<\/jats:p>","DOI":"10.1017\/amj.2026.10101","type":"journal-article","created":{"date-parts":[[2026,9,7]],"date-time":"2026-09-07T13:12:00Z","timestamp":1788786720000},"page":"155-187","source":"Crossref","is-referenced-by-count":0,"title":["The Objectives of Medicaid: The Legal Definition Behind America\u2019s Most Important Health Program"],"prefix":"10.1017","volume":"52","author":[{"given":"Laura S.","family":"Richman","sequence":"first","affiliation":[{"name":"The George Washington University School of Law"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Barak D.","family":"Richman","sequence":"additional","affiliation":[{"name":"The George Washington University"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"56","published-online":{"date-parts":[[2026,9,7]]},"container-title":["American Journal of Law &amp; Medicine"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.cambridge.org\/core\/services\/aop-cambridge-core\/content\/view\/S0098858826101014","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,9,7]],"date-time":"2026-09-07T13:12:02Z","timestamp":1788786722000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.cambridge.org\/core\/product\/identifier\/S0098858826101014\/type\/journal_article"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,7]]},"references-count":0,"journal-issue":{"issue":"2","published-print":{"date-parts":[[2026,7]]}},"alternative-id":["S0098858826101014"],"URL":"https:\/\/doi.org\/10.1017\/amj.2026.10101","relation":{},"ISSN":["0098-8588","2375-835X"],"issn-type":[{"value":"0098-8588","type":"print"},{"value":"2375-835X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,7]]}}}