Jennifer Haley Debunks the Belief That Medicaid Work Requirements Will Push Its Users to Work

Proposals to add work requirements to Medicaid coverage continue to be in the spotlight in federal and state policy discussions.

While some research supporting states and those pushing for these requirements in the Trump administration feel this policy will lead to millions of Medicaid users getting more work, research from the Urban Institute suggests these efforts could potentially harm underserved populations and fail to deliver on promises of improved employment outcomes.

Jennifer Haley, principal research associate of the Health Policy Division at the Urban Institute, told Managed Healthcare Executive her team modeled their analysis on the 2023 Limit, Save, Grow Act, which would have required adults aged 19 to 55 to work or participate in work-related activities for at least 80 hours per month to maintain Medicaid coverage.

While this proposal didn’t officially target Medicaid expansion enrollees, it was created to do so, Haley said.

Related: Medicaid Work Requirements Could Lead to Major Coverage Losses Across Expansion States in the U.S.

Using experiences from Arkansas and New Hampshire, two states that implemented Medicaid work requirements, Haley and her colleagues estimated that many adults would struggle to comply with the new rules.

“Among those who wouldn’t be automatically exempted or deemed compliant, we estimate 72% to 82% would not be able to satisfy that reporting requirement if the patterns follow those in those two states,” she said. “So that gets us to the 5 million adults nationally who would lose federally funded Medicaid.”

Haley also mentioned that these policies do not achieve their intended goals.

“We don’t have any evidence that would suggest these policies would be associated with increases in employment,” she added. “And then the other important thing is our findings are similar with those from other research showing that most people who would be subject to work requirements, in fact, do already work or should be exempt.”

Other research, not of the institute’s, has brought on concerns that expanding Medicaid to more adults takes resources away from more vulnerable populations, such as children, seniors and those with disabilities.

Haley pushed back on this claim and said that Medicaid is an entitlement program without enrollment caps.

She added that states that expanded Medicaid for adults actually spend more per capita on children and people with disabilities than states that have not.

In addition, she pointed out that broader coverage improves overall community well-being, including for families and safety-net providers.

“So those kids and seniors and people with disabilities also would see benefits from having more adults in their communities having Medicaid relative to being uninsured.”