FACT SHEET: Medicaid Work Requirements Would Jeopardize Health
Coverage and Access to Care for 21 Million Americans
Prior research shows that work reporting requirements reduce enrollment in health
coverage, limit access to care, and do not increase employment.
Work requirements would add substantial bureaucratic red tape to Medicaid, putting coverage – and health –
at risk for millions of Americans. Only one state has ever fully implemented these policies, and nearly 1 in 4
adults subject to the policy lost their health coverage – including working people and people with serious
health conditions—with no evidence of increased employment.
1
In fact, research shows that more than 95%
of enrollees subject to the policy already met the requirements or should have qualified for an exemption –
but many lost coverage because they couldn’t navigate the red tape.
2
According to a recent HHS report analyzing 2021 Census data, the vast majority of working-age Medicaid
enrollees are already employed, have a disability, and/or are parents.
3
Previous research indicates that among
enrollees who aren’t already working, nearly all have disabilities, serious health conditions, childcare or
caretaking responsibilities, or are in school.
4,5
Nonetheless, the administrative burden for enrollees to report adherence to or exemption from Medicaid
work requirements could put 21 million Medicaid beneficiaries in this age group at risk of coverage loss.
Administrative churning is a significant issue with Medicaid eligibility redeterminations, and new reporting
requirements will compound this problem.
6
Loss of Medicaid coverage can force patients to change providers,
skip medications, or face financial difficulties, and coverage loss has been tied to worse quality of care and
worse health.
7
The tables below illustrate the estimated number of people in each state and respective counties whose
coverage would be at risk under the general work requirements approach proposed recently by House
leadership.
8
The tables only include states that have expanded Medicaid under the Affordable Care Act, since
the proposed policy would likely affect much smaller numbers of people in non-expansion states.
*
The tables
present enrollment statistics from the Centers for Medicare & Medicare Services (CMS) as of December 2022
(the most recent available data) on the number of adults ages 19 to 55 in Medicaid who are not enrolled via
disability, parent/caretaker, or pregnancy-related eligibility pathways.
It is important to note that, while individuals enrolled through a disability pathway would be excluded from
the new requirements, many people with disabilities enroll in Medicaid via the expansion group pathway, and
their coverage could be at risk. In addition, our estimates do include parents who enroll through the expansion
pathway; while some states may be able to automatically exempt these individuals based on parental status,
this will depend on data availability and how states implement the policy.
Instead of making it harder for people to get health insurance, the Biden-Harris Administration is committed to
working with states to test new innovative ways to deliver health care, lower costs for Americans, and expand
coverage rather than pursue policies that take coverage away from millions of Americans.
*
Nearly all Medicaid enrollees in this age group in non-expansion states are enrolled via eligibility pathways as parents /
caretakers, pregnant, or having a disability; depending on implementation of the policy, these groups would likely be
automatically exempted from the work requirements reporting requirement.