Do Work Requirements for Medicaid Work? WCRI Keynote Questions Conventional Wisdom

Conference Insights

Legislative efforts to get more people working could have an impact on workers’ compensation; after all, getting people on the job means getting those same people under the umbrella of workers’ compensation coverage and rules.

So, then one might assume that the One Big Beautiful Bill Act’s directive for Medicaid recipients to work would have an impact on workers’ compensation; the only problem is, according to Harvard School of Public Health’s Benjamin Sommers, the requirement probably won’t get people on the job, it will just lead to loss of healthcare for people who actually are working.

While there’s not much evidence on what the OBBBA’s rules will do, a 2018 Arkansas study shines light on what’s possible.

“In the Arkansas study, there was little change in the people who weren’t working,” Sommers said. “Most who can work are already working.”

Sommers also noted that the work requirements tended to result in working people getting dropped from Medicaid coverage. While some of the decline could be attributed to working people having other coverage, other cases were chalked up to workers missing a reporting requirement or running out of time to take care of administrative tasks.

“People who are not informed are most likely to lose coverage,” Sommers said. “If you’re seeing the doctor regularly, you’re likely to get assistance.”

Why is it Important?

Less health insurance coverage leads to more people feeling poorly, Sommers said.

“When people have health insurance, they’re more likely to say they feel better,” he said. “And that’s not just subjective, that’s not just their opinion, but the question actually predicts mortality.”

It’s true that expanding Medicaid coverage is expensive, but the question is whether it’s money well spent.

“You do spend more money to cover more people,” Sommers said. “It’s not a cost-saving tool; it’s an investment.”

Is it all doom and gloom from the OBBBA? Not necessarily.

Sommers noted that the new law’s Rural Hospital Fund looks to improve access to care in rural settings. Whether it will be enough to offset coverage losses that come from changes to Medicaid and dwindling Affordable Care Act enrollment after Biden-era subsidies expired remains to be seen, with much depending on state leadership.

“It’s going to help, but hospitals don’t feel confident they will be able to cover what they lose.”

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