Yesterday we looked at the work requirements provision in the One Big Beautiful Bill Act. Today, we turn to another element of the legislation: the requirement that states conduct income and residency checks every six months to ensure that individuals enrolled in Medicaid are still eligible.

This provision may sound technical—just another line item in a sprawling bill—but it raises foundational questions: How should a just society administer welfare? When does compassion become complacency? And how do we ensure that public resources serve the truly needy without encouraging waste or dependency?

This debate isn’t just about red tape or state budgets. It’s about stewardship, personal responsibility, and the moral obligations of both citizens and governments.

The Case for Six-Month Eligibility Checks

Stewardship and Accountability

Scripture teaches that everything we have belongs to God, and we are stewards—not owners—of the resources entrusted to us. That includes public funds. As Paul writes in 1 Corinthians 4:2, “It is required of stewards that they be found faithful.” Government, like any steward, must be held accountable for how it manages taxpayer dollars. In 2023, improper Medicaid payments—often due to outdated eligibility data—cost American taxpayers over $100 billion. That’s not compassion. It’s negligence.

By requiring states to conduct income and residency checks every six months, this provision aims to restore integrity to the Medicaid system. It ensures that aid goes to those who actually meet the legal and financial criteria, rather than individuals who may have moved out of state, gained income, or otherwise become ineligible. In doing so, it helps sustain Medicaid’s long-term viability for those who truly depend on it.

Fairness to the Taxpayer and the Truly Needy

Public aid is not an unlimited resource. Every dollar given to someone who no longer qualifies is a dollar not available for someone who does. Those who defend lax verification protocols in the name of compassion often forget this reality. As Christians, we’re called to help the poor, but helping the poor does not mean tolerating fraud or inefficiency. Proverbs 21:3 reminds us: “To do righteousness and justice is more acceptable to the Lord than sacrifice.”

Moreover, ensuring that programs serve the right people reinforces public trust in those programs. When taxpayers see a system working as intended—serving the vulnerable and not being abused—they are more willing to support it.

Upholding the Dignity of Work and Responsibility

The six-month review also supports a broader cultural message: public benefits are not a substitute for work but a safety net during hardship. By requiring recipients to periodically verify their eligibility, we affirm that receiving public aid is a temporary provision for the vulnerable, not a permanent way of life for the able-bodied. This echoes the biblical mandate in 2 Thessalonians 3:10: “If anyone is not willing to work, let him not eat.”

The Case Against Six-Month Eligibility Checks

To fairly weigh this provision, we must also consider the criticisms, some of which carry real merit.

Risk of Disenrolling Eligible Individuals

Perhaps the strongest concern is that frequent eligibility checks could unintentionally push qualified recipients off the Medicaid rolls due to paperwork errors, misunderstandings, or simple failure to respond in time. Many recipients are elderly, disabled, or non-native English speakers. Without sufficient support, these individuals could fall through the cracks—not because they are ineligible, but because the process is too difficult to navigate.

We must not confuse administrative efficiency with moral clarity. A policy that saves money on paper but causes innocent people to lose life-saving care is not justice, it’s a failure of mercy.

Increased Administrative Costs

Some argue that the cost of implementing biannual checks may rival or exceed the savings from removing ineligible recipients. State Medicaid agencies are already overburdened. Hiring staff, upgrading systems, and managing appeals may prove expensive and cumbersome. While these concerns can be overstated, they are not baseless. Poorly executed reform may create more bureaucracy, not less.

Disruption to Continuity of Care

Inconsistent access to Medicaid can result in disrupted care for chronic illnesses, mental health conditions, or ongoing treatments like chemotherapy. Health care is not like a utility bill you can turn on and off at will. Patients need stable, continuous coverage to manage their conditions effectively. Frequent disenrollment and re-enrollment may exacerbate suffering and raise long-term costs due to untreated conditions.

Stewardship with Safeguards

After reviewing the arguments for and against this provision, I would argue that it’s fundamentally sound. It honors the principle of stewardship, encourages personal responsibility, and seeks to ensure that limited resources are directed to those who truly need them. These are biblical values.

But how we implement such a policy matters deeply. We must not sacrifice compassion on the altar of efficiency.

Yes, states should verify eligibility twice a year, but they must also be required to build systems that are accessible, fair, and user-friendly. That means multilingual support, grace periods, easy digital and paper processes, and active outreach to vulnerable populations.

Christian conservatism does not mean blind deregulation or cold-hearted cost-cutting. It means pursuing righteousness with discernment. It means remembering that every Medicaid recipient is a person made in the image of God, not a line item on a spreadsheet.

If we are to “let justice roll down like waters, and righteousness like an ever-flowing stream” (Amos 5:24), then we must build systems that are just and merciful, firm and kind, prudent and generous.

The six-month eligibility check provision is a step toward greater integrity in our welfare system. But we must ensure the path is paved not only with policy but with love for neighbor and a commitment to biblical justice.