Several states are proposing to tie Medicaid eligibility to employment for many adults. But cutting off Medicaid coverage for people who can’t work or find a job won’t improve their health or help them find or hold a job. Virginia should learn from the experiences of other states and not move forward with any changes that would require work requirements for Medicaid eligibility, and here are five reasons why. 

  1. Medicaid already supports work. Healthy people are better able to get and keep a job. Health insurance for more uninsured adults will allow them to address chronic illness and disease, mental health and addiction problems – conditions which often interfere with the ability to work. E.g., 75% of adults in Ohio’s Medicaid expansion program reported that having Medicaid insurance made it easier to look for work. For those currently working, more than half said that Medicaid made it easier to keep their jobs.
  2. The vast majority of people with Medicaid coverage who can work, are already working. Nearly 8 in 10 non-disabled adults with Medicaid coverage live in working families. Of those not working, a majority reported that illness or a disability was the primary reason.
  3. Work requirements will be costly and complex to implement. The new federal guidance which permits states to impose work conditions through demonstration waivers, includes numerous exemptions and requirements. Actual implementation of those rules would require complex and time-consuming burdens on DSS caseworkers, applicants and enrollees. Stringent verification requirements on individuals to prove disability, work hours, student status, medical conditions etc. are difficult to meet and often lead to erroneous denials. (E.g. Nearly 1/3 of SNAP enrollees who lost benefits for not meeting work requirements, were actually exempt from those requirements, but failed to adequately prove it to the agency.) If required to work, people would need employment supports such as transportation and child-care services. How will such supports be provided and paid for?
  4. Imposition of a work requirement hurts people who need health coverage in order to get and keep a job. Virginia’s uninsured adults need healthcare and employment supports, not punitive measures. Those suffering from illness or addiction are now struggling to survive without the care they need, and the road to treatment and recovery may be long. For example, an addiction expert said, Addiction “… is a disease that hijacks a person’s brain… For some people, getting treatment is a full-time job.”
  5. There are many alternatives to incentivize and support work without harsh penalties. Extend current programs that reward work and help workers secure employer-based health insurance. The state could utilize job-readiness counselors to connect people with existing educational, training and employment opportunities.