A new study of work requirements for Medicaid recipients in Arkansas finds that they did nothing to increase employment but did impose substantial hardships on those who lost coverage as a result of the requirements.
The background: Arkansas was the first state to impose work requirements on some Medicaid beneficiaries, under which adults between the ages of 30 and 49 had to work at least 20 hours per week, be engaged in community activities or receive exemptions in order to continue to receive health care coverage. A federal judge halted the program in April 2019, 10 months after it started, but not before 18,000 adults had been removed from Medicaid for noncompliance.
The findings: The new study, published in Health Affairs, compared those in Arkansas who had been subject to the requirements to those who had not been, and the population in Arkansas to the population in other states. Researchers found no difference in employment rates between populations, contrary to the argument put forth by proponents of work requirements that they would inspire people to get jobs. And they found that at least half of those who lost their Medicaid coverage reported subsequent problems with medical debt, delays in receiving care and delays in taking medications.
The researchers also found that there was considerable confusion about the program rules and serious barriers to reporting participation status for Medicaid recipients in the state.
“In conclusion, our study showed that Arkansas’s work requirements led to coverage losses associated with important negative impacts on medical debt and affordability of care without improving employment,” the researchers wrote. “Our results should provide a strong note of caution for federal and state policy makers considering work requirement policies in the future.”
Joan Alker, a researcher at Georgetown University’s Center for Children and Families who has been a critic of work requirements, said Wednesday that the study shows that Medicaid work requirements are not really designed to help the poor. “Let’s be clear,” Alker said, “this policy is about punishing low income people.”