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Will Medicaid Work Requirements Really Work?

Yesterday, the Center for Medicare and Medicaid Services (CMS) announced that states will have the opportunity to implement work requirements as part of Medicaid, the state-federal health insurance program for low-income people.

North Carolina is one of ten states that has thus far expressed interest in instituting a work requirement for non-disabled Medicaid patients. Such a policy change intends to help raise low-income people out of poverty, and improve their health, says CMS Administrator Seema Verma.

Not all Medicaid enrollees will be tied to one, however. Those who are medically frail, disabled, or who live in high unemployment areas will likely be exempt from the rule.

Will a work requirement tied to medical care really help improve the overall well-being of people who are trapped in poverty?

Policy wonks make the case that work requirements are more effective in  welfare programs other than Medicaid. Robert Rector, a senior research fellow at the Heritage Foundation who is  a leading authority on poverty, welfare programs, and immigration, explains:

A work requirement would just make it less likely for able-bodied adults without dependent children, known as ABAWDs, to register for the program. The work requirement would reduce Medicaid enrollments, but Medicaid costs might well go up because the eligible ABAWDs would go to the emergency room rather than receive routine care elsewhere.”  

While work requirements in Medicaid would be theoretical and symbolic, a serious work requirement for ABAWDs receiving food stamps has already been implemented with great success.

In 2014, Maine implemented work requirements on ABAWDs in the state’s food stamp program. Recipients were not cut off the rolls but were required to undertake training or engage in six hours of community service per week in exchange for their benefits. Within three months the Maine food stamp ABAWD caseload dropped 80 percent. Recipients simply chose to forgo benefits rather than to perform the small amount of community service.

Read more here, and click here to read Rector’s full report.


Katherine Restrepo / Director Of Healthcare Policy

Katherine Restrepo is the Director of Healthcare policy at the John Locke Foundation. Before joining the John Locke Foundation, she interned at the Cato Institute under the di...

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