Are Medicaid Work Requirements Working?

July 19, 2018

Work, study, job hunt or volunteer for at least 80 hours a month.  That was Arkansas’ demand to Medicaid recipients as part of the state’s new Medicaid work requirements, which took effect in June.  One month in, officials are gauging how well the Arkansas Works program is panning out.

Of the 22,000 people expected to be impacted by the requirement, more than 7,000 failed to meet or document meeting the requirement in the program’s first month.  Arkansas Governor Asa Hutchison nevertheless called the numbers “encouraging,” given the early stage of the program.

But not everyone’s on board with the concept – in Arkansas or beyond.

In Michigan, the Cancer Action Network, American Heart Association, American Lung Association, and Leukemia & Lymphoma Society penned a joint letter emphasizing Medicaid recipients’ need for “life-saving coverage.”  Meanwhile, Kentucky’s attempt to impose work requirements was blocked by a federal judge, who determined that the program undermined Medicaid’s core objective: providing health care to low-income citizens. And the president of the American College of Physicians argued that policymakers across the country should instead focus on increasing patients’ access to care.  

Many patients have questions about how “medical frailty” exemptions to the work requirements will be determined.  It’s not clear how chronic conditions such as diabetes, asthma, cardiovascular disease and high cholesterol would be treated.  

The cystic fibrosis community in particular has concerns.  About 45 percent of patients with cystic fibrosis qualify for Medicaid coverage.  The disease decreases patients’ lung capacity, making it difficult to breathe and burdening patients with chronic coughing and wheezing.  Steady work feels outside the realm of possibility for many of these patients.

But for now, patients across the country continue to watch and wait.  In addition to Arkansas, Indiana and New Hampshire have had their work requirements approved by the Trump administration. Seven other states have proposals currently before the federal government.

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