Biden Administration Moves to Roll Back Medicaid State Work Requirements

According to Politico, the Department of Health and Human Services has created a draft rollout plan calling for a rescission of Medicaid Work Requirements, essentially a cancellation of the Trump Administration’s program calling for work requirements to access Medicaid.  This mostly affects any Republican-led states (Arizona, Arkansas, Georgia, Indiana, Nebraska, New Hampshire, Ohio, South Carolina, Utah, Wisconsin) that had applied and been approved for waivers to implement work rules.

The Academy has long been concerned about the impact of work requirements since early impositions of such requirements resulted in loss of insurance for tens of thousands of people.  For example, in Arkansas, the only state to fully implement work requirements, over 18,000 people lost coverage in seven months of implementation of the policy representing 1 in 4 people subject to the requirement.  Further, studies showed that the work requirement increased the number of uninsured people without increasing employment rates.  Although a court case stopped implementation in Michigan, 80,000 people were at risk for loss of coverage.  A study from the Kaiser Family Foundation showed that job losses due to the economic downturn related to the COVID-19 pandemic had the potential to create further loss of coverage due to work requirements.

The move additionally has the possibility of impacting court cases regarding Medicaid work requirements that had worked their way to the Supreme Court.  The court had scheduled oral arguments on the issue for March 29^th in a case which ruled that Arkansas’ work requirements were unlawful and that the ruling applied to similar work requirements in New Hampshire.  Due to the court cases, both Arkansas and New Hampshire’s work rules are technically still pending, and the Administration could move to reject them outright.  Additionally, if the Biden Administration does rescind the guidance in advance of the Supreme Court arguments the court case could be considered moot.

The Academy strongly believes that people’s access to insurance should not be subject to removal based on arbitrary criteria such as work and applauds the Administration’s efforts to resolve this issue.