Center on Budget & Policy Priorities - With congressional Republicans considering proposals to radically restructure Medicaid, some Republican governors are proposing their own sweeping changes to the program, including imposing work requirements on beneficiaries. But as we’ve written, a work requirement in Medicaid would penalize those least able to get and hold a job — while keeping others from improving their health and participating in the workforce.
Many adults on Medicaid are disabled or are caring for a family member. Many others have low-wage jobs that don’t offer health coverage. For those who can work, Medicaid can help them keep their job or search for work. Three-quarters of beneficiaries in Ohio who received care under the Affordable Care Act’s Medicaid expansion and who were looking for work reported that Medicaid made it easier to do so. For those who were currently working, more than half said that Medicaid made it easier to keep their jobs.
A work requirement would likely reduce the number of people who could access care through Medicaid and there’s no evidence that it would increase employment among poor families.
The experience of the Temporary Assistance for Needy Families program is telling. The 1996 welfare reform law converted the Aid to Families with Dependent Children program into the TANF block grant and imposed a work requirement. While touted as a “work opportunity” program, TANF has failed to increase long-term employment among its beneficiaries. Before the 1996 law took effect, 68 every 100 poor families with children received basic cash assistance to help make ends meet; today, just 23 do. Sanctions on parents who didn’t meet a work requirement have been a factor in that drop.