New report finds Medicaid reporting requirements are a raw deal for workers

Sarah Orange
Apr 26, 2018

Many working adults are at risk of losing their health care under new Medicaid work reporting requirement proposals, according to a new report from the Center on Budget and Policy Priorities.

The report examines the work documentation requirement rule that will be implemented in Kentucky this year, which requires non-disabled adults on Medicaid to document 80 hours of work, volunteering, or job training each month in order to receive health care. If people are unable to provide the required documentation, they will lose their health coverage.

Infographic 46 percent of workers at risk of losing coverageThe report found that 46 percent of low-income workers who would be impacted by Kentucky’s new rules would be at risk of losing their health care for one or more months. Even among people who work substantial hours over the course of the year (about 80 hours per month on average), 25 percent would be at risk of losing their health care for one or more months because they would be unable to meet the requirements every single month.

Why is this? Because many of these people work in jobs that have high levels of instability, such as in food service, retail, home health care, or construction. Jobs in these industries frequently have volatile hours or inconsistent scheduling, and no guarantee workers will get to work a consistent number of hours each week. Workers in these types of jobs often don’t have sick time or much say in their work schedules, making it more likely they will lose their jobs if they need to take time to recover from illness, because of gaps in child care, or to deal with a family emergency. Many hardworking people may not be able to meet the 80-hour monthly work requirement through no fault of their own.

While many of the new work rules being implemented, including Kentucky’s, allow workers to fulfill the 80-hour requirement through volunteering or participating in job search programs, this doesn’t solve the problem for many people who are already working. Workers without much control over their schedules or who have to be available to work “on call” will have a difficult time lining up a volunteer position or slot in a job training program on short notice. So while the flexibility is laudable, it does not address the underlying challenges that many low-wage workers face in today’s labor market.

While proponents argue that these proposals will create greater incentives to work and will increase labor force participation, these new rules may actually impede people’s ability to work. Disruptions in health care can have serious consequences for people’s health. People working at low wages have above average rates of chronic health conditions. Not being able to see a doctor or treat an illness may exacerbate health issues further, which in turn make it more difficult to work.

Work documentation rules will likely lead to a vicious cycle: People with health conditions lose their jobs due to illness and then lose their health care, making it even more difficult to get healthy enough to find a new job.

Minnesota is currently considering a proposal that would impose work documentation requirements similar to Kentucky’s. The Center’s report demonstrates how just one of the many unintended consequences of work rules for Medical Assistance (Minnesota’s Medicaid) will not improve the health of Minnesotans and their families, or address barriers to success in the workforce. Instead, it’s clear that Minnesota workers will get a raw deal if reporting requirements are implemented in our state.

-Sarah Orange