What GOP’s plan for Medicaid work requirements would mean

House Republicans’ Medicaid work requirement may leave almost half a million poor Americans without health insurance.

One of dozens of proposals in a GOP bill that would raise the debt limit but cut federal spending over the next decade. The bill is unlikely to pass. House Republicans use it to get Democrats to negotiate and prevent a debt default.

Democrats oppose the Medicaid work requirement, arguing that it will increase the uninsured and discourage job hunting.

The proposal might save taxpayers money but deny some Americans health care.

WHO MUST WORK?
To stay on Medicaid, able-bodied people 19–55 without dependents must work, train, or volunteer. For government-sponsored health care, they must work 80 hours a month.

The Congressional Budget Office predicts 15 million Medicaid recipients would be affected. The Health and Human Services Department expects millions more—about a third of enrollees—to work.

Why are work requirements controversial?
Republicans argue the change would encourage Americans to work and leave government aid.

House Majority Leader Steve Scalise, R-La., said the rules would be fairer for working families.

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“That single mom that’s working two or three jobs right now to make ends meet under this tough economy, she doesn’t want to have to pay for somebody who’s sitting at home,” Scalise added.

Democrats say work requirements might unfairly exclude Medicaid recipients.

Chiquita Brooks-LaSure, administrator of the Centers for Medicare and Medicaid Services, told Congress that Arkansas briefly adopted work requirements and mistakenly threw some people off Medicaid. Some non-workers didn’t fill out the paperwork.

“It’s not just people subject to the requirements that often get caught in red tape,” she noted. “People are often exempt.”

In 2018, 25% of Arkansas’s mandated workers lost coverage.

Medicaid enrollees may struggle with work requirements. In April, the federal government ordered states to reassess income eligibility for all Medicaid members to determine who currently earns too much to receive health care.

New employment, raises, and job changes are costing people coverage.

In April, Rochester, New Hampshire’s Amy Shaw, 39, lost her family’s Medicaid coverage after her husband’s 50-cent raise to $17 per hour at an auto parts business. Since Shaw has two daughters, she wouldn’t be subject to the GOP’s work requirement, but the family’s case shows how modest incomes can push people off Medicaid and cost them big.

She was charged $120 for a doctor-ordered cancer screening instead of $3. Since the pandemic began, food, utilities, and rent have increased by 40%.

“It just seems like the system is set up so that you don’t want to go back (to work) because you lose more than you gain,” Shaw said. It discourages mammograms and colonoscopies. I don’t want to go to these appointments since they’re expensive.”

HOW MUCH WOULD REPUBLICAN PROPOSAL SAVE?
That depends on how many people who must work don’t or don’t fill out the proper paperwork to stay covered.

The Congressional Budget Office thinks the regulations would save $109 billion over 10 years. 600,000 people would be booted from Medicaid, and 900,000 would lose federal funds but stay in the program through their state.

That analysis also says the bill would not boost Medicaid enrollee employment.