Projected Number Of Individuals Affected By Proposed Medicaid Work Requirements: An OPEN MINDS Market Intelligence Report
The Centers for Medicaid & Medicare Services (CMS) under President Trump’s administration has signaled on multiple occasions that they will approve “meritorious innovations that build on the human dignity that comes with training, employment and independence”. As a result, seven states—Arkansas, Indiana, Kansas, Kentucky, Maine, New Hampshire, and Wisconsin—have submitted proposals to CMS to implement work Medicaid work requirements as a condition of enrollment in that program. Additionally, three states—Arizona, Ohio, West Virginia—have announced they are exploring or will submit a proposal related to Medicaid work requirements.
The seven states with proposed waivers have different Medicaid financing and delivery characteristics – including the adoption of Medicaid expansion, utilization of traditional Medicaid managed care financing models, marketplace plans, and premiums charged. The models for work requirements are fairly similar in each state, and only vary slightly in the individuals included, work requirement hours, and types of hours that are included. While work requirements have long been a hallmark of other social service programs, such as the Supplemental Nutrition Assistance Program (SNAP), the inclusion of work requirements in Medicaid has historically been considered antithetical to the spirit of the program.
Whether or not work requirements are seen as a positive in social service programs depends on an individual’s policy and perspective. In terms of increasing family incomes, the impact of work requirements varied by group. What influence or effect these new Medicaid work requirements have on enrollees remains to be seen. This report explores and compares the Medicaid work requirements and characteristics submitted by states and then estimates the number of eligible individuals.