Understanding the Intersection of Medicaid, Work, and COVID-19

The pandemic caused by coronavirus has resulted in a public health crisis but also a major economic crisis. Prior to the pandemic, most Medicaid adults were working in low-wage jobs. Many of these adults could experience job loss or face high health care risks/risks of contracting coronavirus if they retain “essential” jobs in health care or service industries. In both scenarios (i.e., job loss or job retention), current enrollees will retain Medicaid coverage due to “maintenance of eligibility” requirements included in recent federal legislation passed in response to COVID-19 regardless of changes in job status. In addition, many more adults are expected to qualify and enroll in Medicaid coverage as a result of the economic fallout from COVID-19 as people lose jobs, income, and other sources of coverage. This brief highlights data related to the work status and financial security of Medicaid adults prior to the pandemic as well as findings from focus groups conducted with Medicaid enrollees in January 2020. Data and enrollee experiences can inform our understanding of the implications of the pandemic for Medicaid adults and the availability of health coverage for these adults living at or near poverty. Key findings include the following:

  • Prior to the COVID-19 crisis, most Medicaid adults were working or faced barriers to work. Those who report better health and higher levels of education were more likely to be working.
  • Many Medicaid enrollees are employed in occupations where they may face health risks from coronavirus if they are able to maintain their jobs or are deemed “essential” workers.
  • Medicaid enrollees are more likely to be employed by small firms and in industries that are experiencing COVID-related job losses. In addition, one in three Medicaid adults who were working prior to the pandemic were working part-time due to challenges that could be made worse by COVID-19 such as availability of hours or child care limitations.
  • Prior to the COVID-19 crisis, both Medicaid enrollees who were working and not working faced financial insecurity which has likely been exacerbated by the COVID-19 crisis.

Medicaid coverage will support many low-wage workers who may experience additional health risks by continuing to work. In addition, Medicaid included the Affordable Care Act (ACA) Medicaid expansion as well as the ACA’s premium subsidies – will help provide coverage to many more who may become eligible due to job loss and income declines.

Issue Brief