Medicaid and Work Requirements, The Facts

From our friends at the Colorado Consumer Health Initiative.

The Majority of Colorado Medicaid recipients who can work do work.

  • The Department of Health Care Policy and Financing found that 76% of non-elderly adults and children enrolled in Medicaid in Colorado live in a family with at least one part-time or full-time worker.

Non-working Medicaid recipients are either looking for work or face substantial barriers to employment.

  • A Kaiser Family Foundation study[1] found that among unemployed adults who are likely to gain Medicaid coverage in Medicaid expansion states:
    • 29% were not working because they were taking care of home or family,
    • 20% were looking for work,
    • 8% were in school,
    • 17% were ill or disabled, and
    • 10% were retired.
  • In Colorado, the Medicaid expansion offered health coverage for the first time for disabled people on the Aid to Needy Disabled (“AND”) program. Participation in AND requires a determination of disability by the Colorado Department of Human Services.
  • 41,000 veterans in Colorado rely on Medicaid; the total number of veterans on Colorado Medicaid increased by 65% following implementation of the Medicaid expansion.
  • A Medicaid work requirement could prevent people with substance use disorders such as opioid addiction from getting care – care that could allow some people to improve their health and join in the workforce.

Medicaid can help those who can work keep their job or search for employment.

  • An Ohio study found that 8% of those who were unemployed stated that enrollment in Medicaid made it easier to seek employment and 52.1% of those already employed reported Medicaid coverage made it easier to continue working.[2]
  • A University of Michigan study found that 55% of those covered under Medicaid expansion that were out of work said job seeking improved after coverage, and 69% of those already working reported doing better at work after gaining health insurance.[3]
  • A Medicaid work requirement could block people with hourly and seasonal jobs from keeping their coverage. Many low-wage workers have variable hours, and an inflexible work requirement could cost them their coverage if their hours drop — which could make it difficult for them to continue working.
  • Research demonstrates that being insured improves health outcomes and a person’s ability to work. In fact, one study that CMS cites explains that “income does not have a causal effect on life expectancy.”

The data and experience with work requirements in other programs does not support work requirements as an effective tool.

  • The Urban Institute and the Center on Budget and Policy Priorities conducted two different studies on the effectiveness of work requirements in other federal public assistance programs – the Supplemental Nutrition Assistance Program (SNAP), Temporary Assistance for Needy Families (TANF), and federal housing assistance – and found that for each program, most people were already working whether they were subject to work requirements or not,[4] and for those who were out of work, the work requirements did not improve their employment status, and most recipients actually either remained poor or became poorer.[5]

Work requirements reduce low-income families’ access to care and jeopardize children’s health.

  • Parental loss of health insurance caused by work requirements could cause financial and social stress that would have a negative impact on child health and development.






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