WASHINGTON, June 14 -- The Trump administration has finalized the rule that will require millions of Medicaid recipients to prove they are working in order to keep their health coverage, and the most important fact about it is one the administration would rather not lead with: by its own projections, the policy will push millions of people off the program, and the documented evidence says most of them will be people who already work or qualify for an exemption. The requirement is sold as a nudge toward employment. In practice it functions as a coverage-stripping machine powered by paperwork.

The mechanics are straightforward enough. Adults between nineteen and sixty-four who are covered through the Affordable Care Act's Medicaid expansio...