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Experts Respond to Proposed Burdensome Medicaid Work Requirements

By April 25, 2023No Comments

Last week, House Speaker Kevin McCarthy released a plan to change the rules and take away Medicaid coverage from millions of people who currently qualify if they fail to comply with bureaucratic work requirements. The evidence shows the vast majority of people with Medicaid coverage who can work are working, and that applying this type of restriction to non-employment programs, including Medicaid, has significant adverse impacts on health and well-being. 

Millions of people in this country count on Medicaid, especially people with disabilities, people with mental health and substance use disorders, children, pregnant women, seniors in nursing homes, rural Americans, and people of color. This latest Republican scheme would take Medicaid coverage away from those people who count on it the most and make it harder for hospitals, doctors, and other providers in rural and difficult-to-serve areas to stay afloat and stay open. Read more about how Republicans are fighting for health care cuts during Medicaid Awareness Month here.

Georgetown University Health Policy Institute: Medicaid Work Requirement Would Have Damaging Impact. “The Medicaid work reporting requirement provisions contained in Section 321 of House Speaker McCarthy’s draft debt ceiling bill released yesterday are a radical attempt to cut federal funds for Medicaid and will threaten coverage for millions of low-income people — not because people aren’t working but because they fail to jump over a whole new set of bureaucratic hurdles. The vast majority of those who can work do — 93% according to the Kaiser Family Foundation in the Medicaid expansion group are either workers, caregivers, students, or unable to work due to illness. The Speaker’s bill has it backwards – having Medicaid actually support people’s ability to work when they can get their health conditions addressed. Taking it away will only make it harder for them to work.” [Georgetown University, 4/20/23]

Over 30 Patient Groups Including the American Lung Association: This Legislation is a Clear Attack on Quality and Affordable Healthcare. “To be clear: these requirements are not about work, they are about paperwork, and otherwise-eligible patients will lose coverage when they get caught up in this bureaucratic red tape. Additionally, exemption processes inherently create opportunities for administrative errors that jeopardize patients’ access to care. By eliminating the federal match for individuals not in compliance, the legislation leaves no doubt that states would take away coverage from millions of individuals and result in significantly worsened health outcomes.” [4/24/23]

Nearly 230 Medicaid Organizations Sign Letter Opposing McCarthy’s Work Requirement Plan. “Medicaid is a lifeline to 91 million Americans, providing insurance coverage for millions of children, veterans, and people who own and work at small businesses. The program is a critical source of coverage to people who have historically been egregiously underserved by our health care system including people of color, particularly in Black, Latino, Asian American, Native Hawaiian and Pacific Islander, and Indigenous communities, and people living in rural communities. The evidence is clear that when people have a reliable source of high-quality health coverage, they can access critical health services, including preventive care and behavioral health services; experience improved health outcomes and better overall health; and are protected against unexpected medical expenses. These ideas are not new: they were resoundingly rejected by people across the country when they were proposed as part of efforts to repeal the ACA in 2017. Unsurprisingly, the American public continues to strongly oppose them – new polling shows that 71 percent of Americans say it is important to prevent Medicaid cuts. [C]uts to the Medicaid program are unacceptable.” [4/19/23]

Doctors’ Organizations Representing Over 550,000 Physicians 2017 Statement Condemning Work Requirements. “Imposing work requirements, lock-outs, premiums, and other out-of-pocket costs will limit access to preventive and primary care services and inhibit Medicaid beneficiaries from seeking care that helps them avoid costlier health conditions and maintain wellness. Studies show 8 out of 10 Medicaid enrollees are in working families and 59% are working themselves.” [12/8/17]

Statement of ACAP CEO Margaret A. Murray on McCarthy’s Work Requirements Bill. “Nearly two-thirds of adults enrolled in Medicaid already work. Medicaid helps people who work stay on the job. In fact, a survey of people covered by Medicaid in Michigan found that people who had Medicaid coverage were better able to get a job—and keep it. We are also concerned that work requirements will exacerbate ‘churn,’ where people who meet the eligibility requirements for Medicaid are disenrolled owing to paperwork and administrative burdens. Reducing or eliminating health care coverage would impose financial stress on families, limit access to the care they need, and run the risk of denying coverage to people who are Medicaid-eligible.” [4/19/23]