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Henry J. Kaiser Foundation Releases Issue Brief on Proposed Work Requirements Advanced in State Medicaid Programs

May 31, 2017

On March 23, 2017, the Henry J. Kaiser Family Foundation, a nonprofit organization focused on publishing research and information on health care issues in America, published an issue brief that discusses proposed work requirements as part of different state’s Medicaid Section 1115 waivers. Section 1115 demonstration waivers allow states to fund programs for up to five years that promote the objectives of the Medicaid and Children’s Health Insurance Program (CHIP) programs. As of March 2017, four states (i.e., Arizona, Kentucky, Indiana, and Pennsylvania) have submitted waiver requests that would have required beneficiaries to work to be eligible for their Medicaid programs. None of the request has been approved at the time of publication of the brief. Three states (i.e., Indiana, Montana, and New Hampshire) have created voluntary work program referrals that are separate from their Medicaid expansion waivers.

The Kaiser Family Foundation concluded that the previous administration rejected waivers that included work requirements, as it saw these provisions not furthering Medicaid’s goal of promoting health care coverage and access. They believe that the current administration may approve Section 1115 waivers with work requirements. The Kaiser Family Foundation brief weighs the pros and cons of work requirements. They raise concerns that work requirements might create disincentives for people receiving Medicaid services, given that many have disabilities or other health conditions that prevent them from working.

The Kaiser Family Foundation found that work requirements may drive up health care costs when individuals who are denied coverage if they fail to comply with the work requirement, resulting in more use of emergency rooms for medical treatment. The brief notes that work requirements may also increase the administrative burden on Medicaid administrators.

For more information, read the Kaiser Family Foundation’s issue brief.