Understanding the intersection of Medicaid and work: what does the data say?
- Collection:
- Health Policy and Services Research
- Series Title(s):
- Issue brief (Henry J. Kaiser Family Foundation)
- Author(s):
- Garfield, Rachel, author Rudowitz, Robin, author Orgera, Kendal, author Damico, Anthony, author
- Contributor(s):
- Henry J. Kaiser Family Foundation, issuing body.
- Publication:
- [San Francisco, California] : Henry J. Kaiser Family Foundation, August 2019
- Language(s):
- English
- Format:
- Text
- Subject(s):
- Eligibility Determination Employment Medicaid Income Food Supply Poverty State Government Humans United States
- Genre(s):
- Technical Report
- Abstract:
- Under the Trump Administration, the Centers for Medicare and Medicaid Services (CMS) issued guidance for state Medicaid waiver proposals that would impose work requirements in Medicaid as a condition of eligibility, and several states have received approval for or are pursuing these waivers. Work requirement waivers generally require beneficiaries to verify their participation in certain activities, such as employment, job search, or job training programs, for a certain number of hours per week or verify an exemption to receive or retain Medicaid coverage. Details about the specific number of hours, approved activities, exemptions, reporting process, and populations included (e.g., expansion adults and/or low-income parents, age) vary across states. As a result of litigation challenging work requirements, three states (Arkansas, Kentucky and New Hampshire) have had such waivers set aside by the courts. As of July 2019, Indiana is the only other state to have implemented a work requirement waiver. Five more states have approved waivers that are not yet implemented, and another seven states have waiver requests pending with CMS. This brief builds on previous analyses to analyze data on Medicaid enrollees and work and examine some of the policy implications of work requirements. Appendix tables provide state-level data. Key findings include the following: (1) Most Medicaid adults are already working; among those who are not working, most report barriers to work. Those with better health and more education are more likely to be working. (2) Most Medicaid adults who work are working full-time for the full year but are working in low-wage jobs in industries with low employer-sponsored insurance (ESI) offer rates. Industries and occupations with the largest number of workers covered by Medicaid often include jobs that are physically demanding such as food service or construction. Even when working, adults with Medicaid face high rates of financial and food insecurity, as they are still living in or near poverty. (3) Many Medicaid enrollees face barriers to work such as functional disabilities, serious medical conditions, school attendance, and care-taking responsibilities. Many Medicaid adults do not use computers, the internet or email, which could be a barrier in finding a job or complying with policies to report work or exemption status. (4) People who remain eligible for coverage could lose coverage as a result of reporting requirements, and work requirements may not result in increased employment or employer-based health coverage. The outcome of the pending litigation, experience of states' implementation of approved waivers and the outcome of pending waiver requests in non-expansion states will have implications for Medicaid enrollees and for states seeking to adopt similar policies.
- Copyright:
- Reproduced with permission of the copyright holder. Further use of the material is subject to CC BY license. (More information)
- Extent:
- 1 online resource (1 PDF file (19 pages))
- Illustrations:
- Illustrations
- NLM Unique ID:
- 101754969 (See catalog record)
- Permanent Link:
- http://resource.nlm.nih.gov/101754969