Earlier this year, the Trump Administration announced a new policy that allows states to adopt new Medicaid policy initiatives. According to the Centers for Medicare & Medicaid Services, it is designed to improve health by making work a requirement for Medicaid coverage for certain beneficiaries. Several states have begun to implement such programs. During a conference call on Wednesday, officials from the Center on Budget and Policy Priorities said there are a number of harmful unintended consequences occurring in states adopting such policies.The Center on Budget and Policy Priorities, or CBPP, is concerned that mandating work for Medicaid beneficiaries will lead to a number of problems.
CBPP Senior Fellow Judy Solomon says their research shows large numbers of low-wage workers are at risk of losing coverage due to rigid requirements. “Most non-elderly, non-disabled adults enrolled in Medicaid do work. Our research shows that nearly half of low income workers who could be subject to Medicaid work requirements wouldn’t meet an 80 hour a month standard which exists in most of the states with new work requirements, which would put them at risk of losing coverage. One in four people working at least a thousand hours over the course of the year, which averages more than 80 hours a month, wouldn’t meet the standard in at least one month of the year. So while workers aren’t the intended target of these policies they are still at risk of losing coverage.”
States are allowed some flexibility in creating labor requirements to work or volunteer up to 80 hours per month. There are some exemptions, such as pregnant women and the elderly.
Yet CBPP Policy Analyst Jennifer Wagner cites three primary problems to consider if a state wants to implement work requirements for Medicaid recipients. “First of all proposed changes will be difficult for eligible people to navigate, causing eligible people to lose coverage. Second it will be time consuming and difficult for caseworkers to administer and likely lead to many errors, again causing eligible people to lose coverage. And third it will be extremely costly for states to administer, requiring additional staff, but also major reprogramming of eligibility systems, new notices and other administrative expenses.”
Most implementation of work rules is occurring in states outside the Northeast. Solomon refers to New Hampshire and Maine as “outliers” because they are preparing pilot programs. She expects most of the Northeastern region to reject work requirements. “I wouldn’t expect to see them in New York or Connecticut or Massachusetts frankly. In large part these are somewhat ideological. They are coming from a perspective that Medicaid is not you know health coverage that people need to sort of fill the gap. So I think if you look at the states that have embraced the Affordable Care Act like many of the states in the Northeast I would not expect to see any proposals that take coverage away from people who can’t meet a work requirement.”
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