Medicaid Work Requirements Continue to Raise Uncertainty

February 1, 2018

Access to healthcare is a core human service that enables everyone in our communities to build and maintain emotional, physical, and financial well-being. This includes timely and reliable access to high-quality preventive care, as well as services that address differing health and wellness needs throughout life. When people are healthy, they are better equipped to learn, work, and engage with others, which contributes to a thriving nation where everyone can reach their full potential.

In our last issue, we raised the sector’s concerns about the newly permissible option for states to impose work-related requirements on Medicaid recipients, which has the potential to undermine community well-being. While evidence suggests that such requirements would create hurdles to eligibility for many,packaging a state’s new work requirements with the adoption of the Medicaid expansion may ultimately increase the overall number of people eligible for Medicaid.

Since the Medicaid expansion provision was held to be optional for the states in 2012, only 32, and the District of Columbia, have adopted the expansion. This has led to a gap in health care coverage for many low-income families living in the remaining states. While more analysis is needed to determine the net effect of these potential developments, concerns about the risk of work requirements for many populations, particularly people with disabilities, remain valid.

Further, a group of Medicaid recipients recently filed a legal challenge to the Administration’s approval of Kentucky’s work requirements. They contend that the Department of Health and Human Services exceeded its legal authority under Medicaid by permitting states to impose work requirements as a condition of enrollment. Legal experts appear split on the likely success of this argument.