Work requirements could kick 5M off Medicaid

Five million adults could lose their Medicaid coverage next year if Congress enacts work requirements for adults enrolled in Medicaid expansion, according to a new analysis prepared by researchers at the Urban Institute with support from the Robert Wood Johnson Foundation. But researchers say most of these coverage losses would result from low awareness or confusion about the policy, not because people who can work choose not to. The analysis shows more than nine in 10 affected adults work, are looking for a job, or could meet exemption criteria, such as being a family caregiver, attending school, or having a disability.

“Work requirements are a blunt tool that creates costly administrative red tape and separates eligible people from health coverage they rightfully qualify for,” said Katherine Hempstead, senior policy adviser at the Robert Wood Johnson Foundation. “Nearly all adults who gained coverage through Medicaid expansion already meet work requirements. People would not lose healthcare coverage because they are ineligible. They would lose coverage because of the bureaucratic burden the program would put on people across the country.”

The analysis estimates that 4.6 to 5.2 million adults living in states that expanded Medicaid could lose Medicaid coverage next year under federal work requirements. Researchers say if work requirements were applied to a broader population, coverage losses would be even greater.

“Even if work requirements are limited to expansion adults and states use available data to try to automatically identify those who are exempt or compliant, millions of Medicaid enrollees would lose coverage,” said Michael Karpman, principal research associate at the Urban Institute. “Most of these adults would become uninsured and lose access to essential healthcare, including substance use disorder and mental health treatment, medications needed to manage chronic health conditions, and treatment for life-threatening illnesses such as cancer.”

Read the full report, Assessing Potential Coverage Losses among Medicaid Expansion Adults under a Federal Medicaid Work Requirement.