In January, Arkansas applied for a waiver from the federal government to require able-bodied adults on Medicaid to search for work. Medicaid work requirements are now under debate in Congress. As Little Rock Public Radio reports, the effort is all part of the reconciliation bill which U.S. House members narrowly approved in late May.
In an interview on KARK TV’s Capitol View, Keesa Smith-Brantley, director of Arkansas Advocates for Children and Families, said from her experience, while working for the Arkansas Department of Health and Human Services, these work requirements can cause several problems. “Thinking about, at DHS at the time, is not where or not someone wants to work. It’s whether or not they have a job available to work. And so, the real problem with work requirements is that we don’t first look at whether or not there’s availability of quality jobs that will no longer make these individuals eligible for Medicaid.”
But according to a report by the nonprofit Kaiser Family Foundation (KFF), in 2023, most Medicaid adults under age 65 were already working (refer to Figure 1 above), “92% were working full or part-time (64%), or not working due to caregiving responsibilities, illness or disability, or school attendance. The remaining 8% of Medicaid adults reported that they are retired, unable to find work, or were not working for another reason.” The Congressional Budget Office (CBO) estimates work requirements would drop 5.2 million people from the Medicaid rolls.
Arkansas has been down this road before. Back in 2018, Arkansas became the first state to mandate a work requirement for adults enrolled through its Medicaid expansion program. Within just four months 18,000 Medicaid recipients lost their coverage. Only a federal court ruling in 2019 set aside that requirement. The Biden administration would remove that requirement entirely in 2021. The work requirements outlined in the reconciliation bill would provide Medicaid recipients a 30-day notice to return to compliance similar to arkansas’ proposed requirements.
A study by researchers at Harvard University confirmed such requirements were associated with Medicaid coverage loss. But they found no evidence of a positive effect on employment. A separate study published by the U.S. National Institutes of Health came to the very same conclusions.
In fact, Medicaid work requirements in five states actually cost taxpayers $408 million in administrative costs over a three year period. That’s according to a report by KFF, which attributed that figure to a Government Accountability Office (GAO) report.
