Medicaid work requirements would leave more low-income people without health insurance – but this policy is unlikely to pass this time around
The legislative package the
About 1 in 4 Americans have health coverage through the program, which primarily serves low-income and disabled people and which is funded jointly by the federal government and the states. Should the Republican-backed legislation prevail, the federal government would require adults insured by Medicaid who are 19 to 55 years old and don't have children or other dependents to spend 80 hours a month doing paid work, job training or community service.
The Conversation asked
What would change if this policy took effect?
Unlike some other government programs that assist low-income Americans, including the
The package the House recently passed would require all states to implement this policy. An estimated 15 million Americans with Medicaid would need to comply with the requirements.
This change would dramatically increase bureaucratic hassles for Medicaid beneficiaries who are disproportionately low-income, disabled and nonwhite. KFF, a health care research nonprofit, estimates that 1.7 million people would lose federal coverage. However, states have the option to continue to pay for these individuals solely with state funds.
Those who would be subject to the new rules would not be the only ones at risk. It is well known that many of the exempt populations, including the aged and disabled, struggle to complete paperwork or fail to understand complex bureaucratic rules. Many experts predict that coverage losses could be even higher among these demographics, as states would consider them to be out of compliance with work requirements.
Are there precedents for this policy?
This is not the first time that
One exception is
The
Efforts are also underway in
What would be different this time?
States had to actively seek out those waivers that
The proposed changes in the House legislation would force all states to implement work requirements for adults from 18 to 55 without dependents. Failure to comply would put states at risk of losing federal funding, so even Democratic-led states would have to adopt these rules. The proposed changes would also circumvent many of the legal concerns that previously prevented the widespread implementation of Medicaid work requirements.
Importantly, this policy change would coincide with ongoing upheaval for Medicaid beneficiaries. This is because millions of Medicaid beneficiaries are already losing coverage because of the expiration of the COVID-19 public health emergency declaration on
The number of people covered by the program soared to 93 million as of
Is this policy compatible with the purpose of Medicaid?
The point of Medicaid has always been providing eligible low-income people with access to comprehensive health coverage for as long as they need it. That is, Medicaid is exclusively a health insurance program.
Some other safety net programs are supposed to achieve multiple goals. For example, the official mission of Temporary Assistance for Needy Families is to "end the dependence of needy parents on government benefits by promoting job preparation, work and marriage," rather than just to help those needy parents make ends meet.
At the same time, there is evidence that Medicaid leads to greater workforce participation, because it provides affordable health coverage as well as access to needed medical care. If you have an illness, it can be much easier to stay on the job if you're getting the treatment your condition requires. Indeed, most able-bodied adults on Medicaid are employed.
Ironically, pushing people off Medicaid, either for failing to fulfill work requirements or because they struggle with navigating the bureaucracy, would likely reduce the number of people who work.
Why is this significant?
It seems unlikely that Medicaid work requirements will become law in 2023 or 2024, because
For now, I think it's far more likely that the
If measures like the one the House passed as part of the Republican debt-ceiling package were to become law, even states with entrenched Democratic leadership could have little recourse to fight back.
This article is republished from The Conversation under a
Gravie's Comfort® Health Plan Saves Small and Midsize Businesses, Employees Money While Increasing Utilization of Common Healthcare Services
Rupie Phillips: Less government, more competition will benefit health outcomes, bottom line in WV
Advisor News
Annuity News
Health/Employee Benefits News
Life Insurance News