American Indians and Alaska Natives Would Be Disproportionately Hurt by Proposals to Take Away Medicaid From People Not Meeting Work Requirements
As we've written, Medicaid work requirements would reduce access to care and worsen health outcomes for people with disabilities, older Americans, children, working people with unstable jobs, and other vulnerable groups -- but the harm to AI/ANs would be especially severe. As a bipartisan group of senators wrote, work requirements in Medicaid could have "potentially devastating impacts...on AI/AN health access."
Medicaid plays a critical role in AI/Ans' health, covering more than 1 in 4 adult AI/ANs and half of AI/AN children. Medicaid improves access to care, helping reduce the significant mental and physical health disparities that AI/ANs face: compared to non-Hispanic whites, AI/AN adults are twice as likely to be overweight, obese, diagnosed with diabetes, and experience symptoms of mental illness. But the Affordable Care Act's expansion of Medicaid has enabled hundreds of thousands of AI/ANs to gain coverage, making it easier for them to get treatment for their physical and mental health needs.
Proposals to take away Medicaid from people not working or participating in work activities for a specified number of hours each month would reduce access to care and worsen health outcomes for all low-income adults, but especially for AI/ANs, who are disproportionately likely to be unemployed. That's because AI/ANs are likelier to live in areas with limited job opportunities while also experiencing other barriers to employment. The AI/AN unemployment rate averaged 13.1 percent from 2012 through 2016, almost 40 percent higher than the 8.1 percent rate for all other adults. The disparity was even greater in several states that have large AI/AN populations and are now considering work requirements, such as
See table here (https://www.cbpp.org/blog/american-indians-and-alaska-natives-would-be-disproportionately-hurt-by-proposals-to-take-away).
Losing coverage due to work requirements would put any enrollee's health at risk, which is why physician organizations like the
Through the debate about exempting AI/ANs from work requirements, some policymakers have come to recognize how harmful these measures would be to this group. But the right lesson to draw is that no vulnerable low-income enrollees -- including AI/ANs -- should lose their health coverage and access to care if they can't meet rigid work requirements.
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