Recent guidance from the Centers for Medicare & Medicaid Services (CMS) allows states to require Medicaid recipients to work in order to receive their health coverage. If Florida were to adopt such an approach, as a growing number of states have begun to do, thousands of residents would likely lose their access to health care.1
While the premise of work requirements, that they will support the development of workplace skills and economic independence, may sound appealing, in fact, it is fundamentally flawed. First, it assumes that Medicaid recipients are not working, when in fact, 61% of adult Medicaid enrollees in Florida work. Nationally, of those who aren’t working, more than 80% are in school or report an illness, disability, or caregiving responsibilities that keep them from working.
Additionally, work requirements subject people to burdensome paperwork and documentation requirements, which too often lead ultimately to loss of coverage. In other words, work requirements cause recipients who are already working, or are duly exempt from work, to lose their Medicaid because of administrative errors, and/or the system’s inflexibility (e.g. late paperwork, administrative errors, insufficient work hours in a given month, or a brief spell between jobs). The remaining individuals, who are neither working nor ill, disabled, or caregiving, likely don’t lack motivation to work, but supports that make work possible such as child care, and access to transportation. Further, in a state like Florida, that has not expanded Medicaid; the pool of able-bodied adults who would be subject to work requirements is quite limited, further underscoring the illogic of work requirements here.
Having health care helps people work and look for work. Ironically, taking it away will make it more difficult for many people to keep their jobs, or find a new job. Anticipated coverage losses that would come with work requirements will make health outcomes worse, access to care more difficult, and will make any growth in employment rates among recipients highly unlikely. In fact, a recent study of the first ever Medicaid work requirements, implemented in Arkansas found precisely these outcomes: thousands of people lost their Medicaid while there was no significant change in employment. Work requirements, it turns out, don’t work.
If you or someone you know is on Medicaid and want to learn more about this potential change to the Florida program, please contact us.
1 When work requirements have been challenged in federal court, they have been twice struck down, in Arkansas and Kentucky.