What You Should Know:
– Proposed work requirements for Medicaid could lead to millions of Americans losing their health insurance, according to a new analysis by the Urban Institute with support from the Robert Wood Johnson Foundation.
– The analysis projects that 4.6 to 5.2 million adults living in states that expanded Medicaid could lose their coverage in 2026 if work requirements are enacted.
Key Findings
Researchers caution that if work requirements were applied to a broader population, the number of coverage losses would be even greater. While proponents of work requirements argue that they encourage employment, the report suggests that most coverage losses would stem from a lack of awareness or confusion about the policy, rather than a disinterest in working. The analysis indicates that over 90% of adults who would be subject to work requirements are already working, looking for a job, or could meet exemption criteria, such as being a family caregiver, attending school, or having a disability.
The analysis draws on lessons from Arkansas and New Hampshire, two states that previously implemented Medicaid work requirements. Researchers applied program experiences from these states to national data to project the impact of federal work requirements similar to those proposed in the Limit, Save, Grow Act, a 2023 bill passed by the House.
The report concludes that even if states attempt to use data to automatically exempt enrollees, many Medicaid enrollees who are working, engaged in work-related activities, or are meant to be exempt could still lose coverage and access to healthcare.
“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.”