There is substantial research that says that conditional care like what you propose is often used as a cudgel to deny Government assistance to those that need it the most.

In other words, I think the cost of putting in these guardrails, often with good intentions, is that they're misused against minorities and the poor. If that's the case, I would rather a few freeloaders/bad decision makers abuse it rather than the most needy going without the healthcare they desperately want.