A recent National Health Law Program (NHeLP) issue brief, “Unfit” to Work? How Medicaid Work Requirements Hurt People with Disabilities, explores how work requirements in Medicaid particularly harm individuals with disabilities. Examining work requirements and proposals, the issue brief makes clear that “work requirements keep people from getting the health care they need, without actually helping people work. Work requirements are, quite simply, cuts.”
Some highlights, directly quoted from the issue brief:
- “[T]here is no way to “target” work requirements to a specific group of low-income Medicaid enrollees who supposedly lack incentive to work, because that group does not exist. The vast majority of Medicaid-enrolled adults are already in the paid workforce or they have really good reasons to not be.”
- “[T]he likely consequence of any federal Medicaid work requirement is the exact opposite of what proponents claim they want to encourage. People with disabilities would be more likely to abandon employment due to the existential risk of losing their benefits.”
- “In 2018 Arkansas implemented a work requirement for some Medicaid enrollees and proceeded to cut coverage for over 18,000 participants in just 7 months, or roughly 23% of the targeted population in 2018. Many of the terminated Arkansans never even heard about the work requirement or had difficulty reporting their hours or seeking an exemption.”
- “Numerous studies of TANF [Temporary Assistance for Needy Families] work requirements have documented disproportionate sanctioning of participants with physical and mental health conditions. . . . These same studies found that Black participants were also more likely to be sanctioned for failure to comply with TANF work requirements, suggesting that racial and ethnic bias may compound the negative impact of work requirements for people of color with disabilities.”
- “Millions of adults with chronic conditions and disabilities rely on Medicaid to stay active members of their communities.”
- “Programs like the Ticket to Work program or the Medicaid Buy-in for Workers with Disabilities allow participants with disabilities to pay sliding scale premiums for Medicaid coverage if their incomes exceed eligibility thresholds. That allows them to continue receiving critical home and community-based services (HCBS) that help them stay in the workforce.”
- “Medicaid expansion, which created a new Medicaid eligibility category for working age adults, allowed millions of people with disabilities to enroll in Medicaid for the first time. This includes, for example, people with mental and behavioral health conditions who do not meet the strict disability criteria for common Medicaid disability-specific eligibility categories. It also includes people who meet the strict criteria but had a household income just above the extremely low Medicaid income/resource thresholds for those categories.”
January 2, 2024 – K. Kertesz