Published by: Medicare Rights Center
Some policymakers are attempting to add bureaucratic barriers to Medicaid that would put health coverage for millions of people at risk. On April 26, the Republican-led House of Representatives advanced legislation linking a debt limit increase to harmful funding cuts and policies, including adding complex work requirements to Medicaid starting in 2024.
The evidence is clear that such requirements do not further the Medicaid program’s objectives, and instead create barriers to care and put coverage at risk. For example, a recent Kaiser Family Foundation (KFF) analysis shows that Medicaid work and reporting requirements are confusing to enrollees and can result in substantial coverage loss, even if they meet the underlying requirements. In an earlier report, KFF found that if all states implemented work requirements, most disenrollment would be among individuals who would lose coverage due to the new administrative burdens, rather than due to noncompliance with the actual work requirements. Many of these adults would become uninsured and pay more for health care.
Adding Medicaid work requirements nationally could affect millions of enrollees. In assessing the current proposals, the Congressional Budget Office (CBO) estimates that around 15 million people would be subject to work requirements and in danger of losing coverage. HHS estimates that number would be closer to 21 million. The likely administrative burdens would be significant, partially because many adults with Medicaid do not use computers, the internet, or email, which could be a barrier in finding a job or complying with policies to report work or exemption status. Adults over 50 face particular challenges in complying, and the health consequences, if they lose Medicaid coverage, are likely to be especially severe. Research has shown that for people with serious health needs, coverage interruptions lead to increased emergency room visits and hospitalizations, admissions to mental health facilities, and health care costs.