Medicaid Work Requirements Don't Impact Many Enrollees
TUESDAY, Sept. 11, 2018 -- Medicaid work requirements will only impact a small proportion of persons and may only generate minimal savings, according to two research letters published online Sept. 10 in JAMA Internal Medicine.
Anna L. Goldman, M.D., from Cambridge Health Alliance in Massachusetts, and colleagues used the 2015 Medical Expenditure Panel Survey to estimate the number of Medicaid enrollees at risk of losing coverage if work requirements are implemented with the exemptions specified in approved waiver applications. Using the Medicaid Budget and Expenditure System, current Medicaid spending was calculated for those enrollees at the national level and among states with approved or pending waivers. The researchers found that most Medicaid enrollees were already working or exempt, but if work requirements were applied nationally with all of the exemptions applied, 2.1 million persons could be at risk for disenrollment (2.8 percent of current Medicaid enrollees). However, the potentially disenrolled account for 0.7 percent of Medicaid spending.
In the second study, David M. Silvestri, M.D., from Yale University in New Haven, Conn., and colleagues used the 2014 Survey on Income and Program Participation in order to model Medicaid eligibility using state-specific income thresholds, and work requirement exemption and fulfillment criteria based on submitted waiver applications. The researchers found that among the 11 states with submitted waiver applications, 3.9 percent to 29.2 percent of Medicaid-eligible individuals, including 21.8 to 54.0 percent of non-disabled Medicaid-eligible adults, were subject to (not exempt from) proposed work requirements.
"In light of these findings, policymakers should consider whether administrative costs and beneficiary burdens imposed by work requirements are justified by their narrow projected reach," Silvestri writes.
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Posted: September 2018