We've talked about Medicaid work requirements before. There's a new study out there on what's happening in the real world. This is Healthcare Triage News.

[Intro]

To the research!

The Urban Institute has a new study out: Many Adults Targeted by Medicaid Work Requirements Face Barriers to Sustained Employment. Let's review.

In case you missed our multi-part series on work requirements, for more than a year CMS has been approving waivers that allow states to put in place work requirements for people to get Medicaid. They require non-elderly adults who aren't pregnant and who don't have a disability that prevents them from working to actually engage in work-related activities for 20 hours per week or 80 hours per month to get their Medicaid. States have been rushing to do this, even though we don't know what might actually happen when they do.

This study uses the Health Reform Monitoring Survey, which is a nationally-representative sample of non-elderly adults, to examine both work patterns and potential barriers to work among those who would fall under the work requirements. It compared them to Medicaid enrollees exempt from work requirements and privately insured adults. 

They key points are instructive. Among those who couldn't always meet the 20 hours bar, half reported trouble finding work, employer restrictions on schedules, temporary, seasonal, or part-time employment, or involuntarily reduced hours. Meaning that working less wasn't their choice.

More than 20% of those who were subject to work requirement rules didn't have a high school diploma or GED. That's five times less likely to have graduated from high school than those who are privately insured. That would make it harder to find a job, of course.

More than 25% of those who are subject to work requirements report having more than one chronic health condition. That would also make it harder to work. It would also make having health insurance, and the health care it provides access to, even more important.

People who are subject to Medicaid work requirements had less access to transportation, which is often needed to get a job. They were also more likely to live in places where the poverty rate's above 20%, meaning lots of people want jobs, but there aren't many available.

Remember that most Medicaid enrollees work or are exempt from requirements. We're talking about a small percentage of beneficiaries, but data like these show that they're different from those who do work or are exempt. They are legitimately unable to work.

Now, if we want to invest in education, or training, or help getting jobs, or if we want to make more jobs available, that's great. But, this policy is all stick and no carrot, and that usually doesn't work out so well.

The goal of policies like work requirements, as we've discussed at length, should be to get more people to have a better life. We want them to work so that they can be lifted out of poverty. But, if we're just punishing people who already can't find work, often because they're sick, by taking away their health insurance, that's likely not going to help them get a job. It's just going to make them worse off. That's not the goal here.

[Outro]

Hey, did you like this episode? You might also like our whole series on work requirements. Click right here to go watch.

Also, go to Patreon.com/HealthcareTriage. Great way to support the show. We'd especially like to thank our research associate, Joe Sevits, and, of course, our surgeon admiral, Sam.

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