Medicaid Medicaid/Medicare Public Policy

The end of Medicaid work requirements?

Last week, a federal judge blocked Arkansas and Kentucky from requiring individuals to work in order to receive Medicaid benefits. Prior to that decision, 9 states had been approved to implement Medicaid work requirements.

Medicaid Work requirement Waivers.
Source: North Carolina Health News.

At first glance, a work requirement does not make a lot of sense. If you are very sick and on Medicaid, how could you work? Also, if you worked and earned too much money, you may no longer qualify for Medicaid. On the former point, the N.Y. Times reports that:

Both the Kentucky and Arkansas rules allowed exemptions for people deemed too sick to work, pregnant women, full-time students or primary caregivers of dependent children or disabled family members.

Now the program makes a bit more sense. If you are able to work, not a student or pregnant, or a primary caregiver, having people work may help them get out of poverty and on the road to recovery and private insurance.

However, how does one determine if you are “too sick to work”? In some cases this may be easy, but other cases more difficult. What if you have debilitating back pain? Does that count as too sick to work? And how would the government determine this? If you were very sick, would you really want to be sending a lot of time filling out government paperwork to be exempt from the work requirement?

Thus, while the work requirement may be a viable policy in theory, but in practice, it is likely to move the healthiest individuals off of Medicaid (because they will now need to work at least 80 hours per month and their incomes make them ineligible) and make the sickest people ineligible due to the work requirement.

Well, at least that chapter of Medicaid history is over, right?

Well, actually, Arkansas and Kentucky are pressing on to try to implement the work requirements.

“I remain fully committed to a work requirement and we are in this for the long-haul because we believe it is the right policy,” [Arkansas governor Asa] Hutchinson said at a news conference. “There should be consequences if people don’t exercise responsibility.”

These changing policies may be enough to give you whiplash.


  1. I support the decision of the court. President Trump supports the idea of ​​introducing employment requirements for government benefits. Last year, he signed a decree that government agencies had to add or strengthen employment requirements in benefit programs, including subsidized housing, food stamps and cash benefits. The Department of Health and Human Services has already begun to act in this direction, urging the states to submit requests to establish employment requirements for Medicaid. Good luck!

  2. People should have a sense of responsibility. Just because of 1 or 2 who misuses the system, everyone else has to suffer the price. It’s not fair for the others and yet, that is how this world works.

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