House Republicans have put Medicaid at the top of their federal government chopping block. Their budget plan that passed on February 25 would direct the Energy and Commerce Committee (which has responsibility for Medicaid and other health programs) to come up with at least $880 billion in savings to pay for extending the 2017 Trump tax cuts. Medicaid is at the greatest risk of facing cuts.

Republican leaders are trying to make you think that the 70 million beneficiaries of the Medicaid program do not work. The solution, they say? Work requirements. By making people prove that they work in order to receive healthcare, the federal government will become more “efficient.” But decades of evidence tell us that this is a phony argument.

While all this blather about work requirements is just a cover for Republicans’ real goal –  tax cuts for the wealthy – they don’t dare say this out loud because Medicaid is enormously popular. But so, too, are work requirements – many Americans (80 percent of Republicans and 49% of Democrats) support the idea that Medicaid recipients should show proof of work to receive benefits, according to this Axios poll.

But this should not be interpreted as support for the Republican work proposal. What most people likely don’t know is that nearly two-thirds of Medicaid beneficiaries already work, and most of the others would not be required to work because they are caregivers, disabled, or in school. Just 8% of Medicaid beneficiaries are not in one of these categories. This means that efforts to use work requirements to increase employment of Medicaid recipients are doomed to fail; they are attempting to force a reality that already exists.

There is a wealth of research documenting that Medicaid work requirements are unsuccessful in increasing employment. But they are effective at doing something else: Unenrolling people who are eligible for Medicaid. In other words, more paperwork  and less healthcare.The Congressional Budget Office analyzed previous bills that institute work requirements and found they would have led many to lose coverage with “no change in employment or hours worked”.

The Center on Budget and Policy Priorities estimates that as many as 36 million people could lose their insurance if work requirements are implemented in Medicaid. You might ask, if most people are already working, why would so many lose coverage? The reality is that Medicaid and many social programs are difficult and complicated to sign up for and navigate, especially when many beneficiaries are facing chronic illness and disability. If work requirements are implemented, everyone on Medicaid would need to navigate a new system to show they are exempt. Besides, states already collect data for most people’s employment status, thanks to reports that employers file with the unemployment insurance program. There is no reason to make workers jump through additional hoops to report this information.

The harms to people across the country would dramatically outweigh whatever savings Republicans have calculated they will earn from work requirements. The Congressional Budget Office estimated that a work requirement proposed in 2023 would save the federal government $109 billion over 10 years. This is a fraction – about 5.7% – of the $1.9 trillion that extending the 2017 Trump tax law would cost over a decade. Republicans are signaling that millionaires and billionaires paying less in taxes is far more important than making sure that millions of Americans have health insurance coverage.