New Health and Medicine Study Results from Beth Israel Deaconess Medical Center Described (Insurance coverage and employment after Medicaid expansion with work requirements: quasi-experimental difference-in-differences study): Health and Medicine

2025 OCT 10 (NewsRx) -- By a News Reporter-Staff News Editor at Insurance Daily News -- Fresh data on Health and Medicine are presented in a new report. According to news reporting from Boston, Massachusetts, by NewsRx journalists, research stated, “To understand how health insurance coverage and employment changed among working age adults with low incomes in Georgia, the first state to implement Medicaid expansion with work requirements under the Pathways to Coverage program. Quasi-experimental difference-in-differences study. Georgia, which expanded Medicaid with work requirements on 1 July 2023; Alabama, Florida, Mississippi, South Carolina, and Tennessee, which neighbor Georgia and did not expand Medicaid; and South Dakota, which simultaneously expanded Medicaid without work requirements.”

The news correspondents obtained a quote from the research from Beth Israel Deaconess Medical Center, “Adults aged 19-64 years with low incomes defined as 100% of the federal poverty level who completed the US Census Bureau’s household pulse survey between 2021 and 2024. Medicaid coverage, uninsured rate, and employment. The study population consisted of 3303 adults in Georgia (intervention state) and 14 148 in neighboring states that did not expand Medicaid (controls). After the implementation of Pathways to Coverage, Medicaid coverage did not change in Georgia (35.5% to 32.4%) or in neighboring control states (39.6% to 39.3%), resulting in no differential change in Medicaid coverage between these states (adjusted difference-in-differences -3.0 percentage points, 95% confidence interval -7.6 to 1.6). These patterns were similar for the uninsured rate (-2.3 percentage points, -6.9 to 2.3). Additionally, employment did not increase in Georgia compared with control states (-1.6 percentage points, -8.7 to 5.4). In a secondary analysis that aimed to isolate the effects of work requirements, Medicaid coverage did not change in Georgia (35.5% to 32.4%) but increased in South Dakota (36.6% to 44.6%)-a state that expanded Medicaid without work requirements-resulting in a differential decrease in coverage in Georgia relative to South Dakota (-11.7 percentage points, -19.5 to -3.9). There was no differential change in employment (-0.1 percentage points, -9.8 to 9.6) between these states. The implementation of work requirements with Medicaid expansion in Georgia did not increase health insurance coverage or employment during the first 15 months of the program.”

According to the news reporters, the research concluded: “These findings have important implications as US policy makers recently enacted legislation that will mandate work requirements in Medicaid programs across all US states beginning in 2026.”

This research has been peer-reviewed.

For more information on this research see: Insurance coverage and employment after Medicaid expansion with work requirements: quasi-experimental difference-in-differences study. BMJ, 2025;390. BMJ can be contacted at: Bmj Publishing Group, British Med Assoc House, Tavistock Square, London WC1H 9JR, England. (BMJ Publishing Group - http://group.bmj.com/; BMJ - http://casereports.bmj.com/)

Our news journalists report that additional information may be obtained by contacting Stephen A. Mein, Section of Health Policy, Richard A and Susan F Smith Center for Outcomes Research, Beth Israel Deaconess Medical Center, Boston, MA, United States. Additional authors for this research include Daniel Y. Johnson, Lucas X. Marinacci, Michael Liu and Rishi K. Wadhera.

The direct object identifier (DOI) for that additional information is: https://doi.org/10.1136/bmj-2025-086792. This DOI is a link to an online electronic document that is either free or for purchase, and can be your direct source for a journal article and its citation.

Publisher contact information for the journal BMJ is: Bmj Publishing Group, British Med Assoc House, Tavistock Square, London WC1H 9JR, England.

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