Recent analyses and pilot programs demonstrate that Medicaid work requirements consistently fail to increase employment among beneficiaries and instead result in significant coverage losses, according to journalist and author Matthew Chapman. In a recent social media post, Chapman stated, > "Every single study I've read of previous Medicaid work requirement pilot programs shows they don't do any of these things, by the way." This assertion aligns with findings from various research institutions and government estimates.
The Congressional Budget Office (CBO) estimated that a 2023 proposal for Medicaid work requirements could lead to 1.5 million people losing eligibility for federal funding, with no increase in overall employment. The CBO's analysis cited evidence from Arkansas, the only state to fully implement such a requirement with disenrollment for noncompliance.
Arkansas's program, in effect from June 2018 to March 2019, saw over 18,000 people lose coverage, representing about 25% of the population subject to the rule. Most disenrollments were due to administrative hurdles, such as failure to report work status, rather than an inability to meet the work hours. Research indicates that many who lost coverage were already working or qualified for exemptions but faced difficulties navigating complex reporting systems.
Experts from organizations like the Kaiser Family Foundation and the Center on Budget and Policy Priorities consistently highlight that the majority of Medicaid enrollees are already working, or are not working due to valid reasons such as caregiving responsibilities, illness, or disability. Work requirements disproportionately affect vulnerable populations, including those who should be exempt but lose coverage due to red tape.
Studies on similar work requirements in other federal programs like Temporary Assistance for Needy Families (TANF) and the Supplemental Nutrition Assistance Program (SNAP) also show modest, often temporary, employment gains that do not significantly reduce poverty. Critics argue that Medicaid work requirements primarily serve as a cost-cutting measure by reducing enrollment, rather than a genuine strategy to promote self-sufficiency.
While Georgia currently operates a work requirement waiver, the overall evidence from past implementations suggests that these policies create administrative barriers, leading to a rise in uninsured individuals without achieving their stated goal of increased employment. This outcome underscores the concerns raised by Chapman and other policy analysts regarding the efficacy and impact of such mandates.