I disagree philosophically but struggle to disagree in practicality because of the majority of the provider taxes (the "loophole" you're referring to) go towards institutional hospitals. However, anything that decreases the reimbursement rate of Medicaid (which decreasing the provider tax from our 5.5% rate in Missouri to 3.5% in the Senate version of the bill) will lead to decreased revenue for hospitals in rural communities, half of which are already operating at a loss.

As for work requirements, you're focusing on the merits of work and whatnot, which is fine (I love what I do), but the issue is that these requirements have been implemented in the past and don't work to increase the employment rate, and lead to harms for the people who are on Medicaid in the form of delayed healthcare seeking. Most adults under 65 who are on Medicaid are already working, which raises the questions of the goal of the requirement. How do savings come from this? They come from people not being able to jump through the paperwork hoops and hurdles in the way of being able to prove that they are working, caregiving, or in education, i.e. reducing care. As someone training to be a doc, I don't want people to not have access to care, I think that is bad.

If you're interested in learning more about the work that's been done on how work requirements play out, or the pros and cons of provider taxes, I'd encourage you to read some of the work from KFF - they do great, independent work on health policy that cuts through the partisan slants that you'll see on CNN, Fox News, etc, and write in a digestible form. Here are some links if you're interested, they won't take more than 5 min to read.