Adding a federal work requirement to Medicaid won’t root out “waste, fraud, and abuse” as many lawmakers are claiming—instead, the move will likely push eligible people out of their health coverage, says Harvard T.H. Chan School of Public Health’s Adrianna McIntyre.
McIntyre, assistant professor of health policy and politics in the Department of Health Policy and Management, spoke to CNN on June 2 about the potential impacts of a federal requirement that Medicaid enrollees regularly demonstrate they are working, volunteering, or in school in order to maintain their coverage. (Certain enrollees would be exempt from the work requirement, such as those who have a demonstrated disability or who are full-time caregivers.)
Proponents of the proposed work requirement argue that it will make Medicaid fairer and more efficient. But according to McIntyre, it’s “a solution in search of a problem.”
“Most people in Medicaid are working at least part-time,” she told CNN. “And the overwhelming majority of the remainder qualify for … exemptions. They care for older relatives or children. They’re in school. They’re volunteering.” Given this reality, a Medicaid work requirement is unlikely to boost employment rates among Medicaid enrollees, McIntyre said. Rather, it will likely boost the burden of reporting employment or exemptions.
“The government does not magically know that you’re caring for your disabled mom,” McIntyre explained. “You’re going to have to go in and file paperwork at least twice a year under this bill—possibly more often.” As a result, she said, eligible people will slip through the cracks. “We’re going to have people showing up at doctor’s offices, at pharmacies, and learning only when they’re trying to get their medications that they no longer have coverage,” she said.
McIntyre noted that when Arkansas added work requirements to its Medicaid programs, “we saw a bunch of people who seemed to be perfectly compliant … losing coverage, largely because they didn’t know that they needed to … be logging on to a website, telling the government that they’re working.” More recently, she said, Georgia saw Medicaid enrollment stagnate after the state added a work requirement, likely because people couldn’t keep up with necessary reporting.
In general, McIntyre said, the proposals lawmakers are considering “aren’t work requirements. They’re paperwork requirements.”
Watch the CNN interview
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Medicaid cuts: What’s at stake (Harvard Chan School news)
