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Implications of a Medicaid Work Requirement: National Estimates of Potential Coverage Losses

Issue Brief
  1. The large majority (about three quarters) of part-time workers work at least 20 hours per week.

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  2. Emily Badger and Margot Sanger-Katz, “Which Poor People Shouldn’t Have to Work for Aid?” New York Times, May 15, 2018.  https://www.nytimes.com/2018/05/15/upshot/medicaid-poor-michigan-work-requirements.html

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Appendix
  1. Jennifer Edwards, Lisa Duchon, Eileen Ellis, et al. Maximizing Enrollment for Kids: Results from a Diagnostic Assessment of Enrollment and Retention in Eight States. National Academy for State Health Policy and Robert Wood Johnson Foundation, February 2010. http://www.maxenroll.org/files/maxenroll/file/Synthesis%20-%20FINAL%20-%20for%20posting%20(2).pdf

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  2. Robert Seifert, Garrett Kirk, and Margaret Oakes. Enrollment and Disenrollment in MassHealth and Commonwealth Care. Massachusetts Medicaid Policy, April 2010. http://www.maxenroll.org/files/maxenroll/resources/EnrollmentinMHandCC-final-april2%20(2).pdf

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  3. Benjamin Sommers. “From Medicaid to Uninsured: Drop-Out among Children in Public Insurance.” Health Services Research. 2005 Feb; 40(1): 59–78.

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  4. Robert Seifert, Garrett Kirk, and Margaret Oakes. Enrollment and Disenrollment in MassHealth and Commonwealth Care. Massachusetts Medicaid Policy, April 2010. http://www.maxenroll.org/files/maxenroll/resources/EnrollmentinMHandCC-final-april2%20(2).pdf

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  5. Benjamin Sommers. “Loss of Health Insurance Among Non-elderly Adults in Medicaid.” Journal of General Internal Medicine. 2009 January; 24(1): 1–7.

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  6. Robert Seifert, Garrett Kirk, and Margaret Oakes. Enrollment and Disenrollment in MassHealth and Commonwealth Care. Massachusetts Medicaid Policy, April 2010. http://www.maxenroll.org/files/maxenroll/resources/EnrollmentinMHandCC-final-april2%20(2).pdf

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  7. Jennifer Edwards, Lisa Duchon, Eileen Ellis, et al. Maximizing Enrollment for Kids: Results from a Diagnostic Assessment of Enrollment and Retention in Eight States. National Academy for State Health Policy and Robert Wood Johnson Foundation, February 2010. http://www.maxenroll.org/files/maxenroll/file/Synthesis%20-%20FINAL%20-%20for%20posting%20(2).pdf

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  8. Kaiser Commission on Medicaid and the Uninsured. Using Data and Technology to Drive Process Improvement in Medicaid and CHIP: Lessons From South Carolina. Kaiser Family Foundation, March 2012.  https://www.kff.org/medicaid/fact-sheet/using-data-and-technology-to-drive-process/

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  9. Donna Cohen Ross and Laura Cox. In a Time of Growing Need: State Choices Influence Health Coverage Access for Children and Families A 50 State Update on Eligibility Rules, Enrollment and Renewal Procedures, and Cost-Sharing Practices in Medicaid and SCHIP for Children and Families. Kaiser Family Foundation, October 2005. https://www.cbpp.org/archiveSite/10-18-05health.pdf

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  10. Jennifer Edwards, Lisa Duchon, Eileen Ellis, et al. Maximizing Enrollment for Kids: Results from a Diagnostic Assessment of Enrollment and Retention in Eight States. National Academy for State Health Policy and Robert Wood Johnson Foundation, February 2010. http://www.maxenroll.org/files/maxenroll/file/Synthesis%20-%20FINAL%20-%20for%20posting%20(2).pdf

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  11. Laura Summer and Cindy Mann. Instability of Public Health Insurance Coverage for Children and Their Families: Causes, Consequences, and Remedies. The Commonwealth Fund, June 2006.  http://www.commonwealthfund.org/publications/fund-reports/2006/jun/instability-of-public-health-insurance-coverage-for-children-and-their-families--causes--consequence

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  12. Anne Dunkelberg and Molly O’Malley. Children' Medicaid and SCHIP in Texas: Tracking the Impact of Budget Cuts. Kaiser Family Foundation, July 2004. https://www.kff.org/medicaid/report/childrens-medicaid-and-schip-in-texas-tracking/.

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  13. Jill Boylston Herndon, Elizabeth A. Shenkman, and Bruce Vogel. The Impact of Renewal Policy Changes in the Florida Healthy Kids Program. Report Prepared for the Florida Healthy Kids Corporation, 2006-2007 Florida Healthy Kids Program Evaluation. January 2007. https://www.healthykids.org/documents/evaluation/institute/2007/tab_l.pdf

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  14. Andrew Dick, R. Andrew Allison, Susan Haber, et al. “Consequences of States' Policies for SCHIP Disenrollment.” Health Care Financing Review. 2002 Spring; 23(3): 65–88. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4194770/

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  15. Erin Brantley and Leighton Ku. “Work Requirements: SNAP Data Show Medicaid Losses Could Be Much Faster And Deeper Than Projected.” Health Affairs (blog).  April 2018. DOI: 10.1377/hblog20180412.310199.

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  16. CBO Estimate of H.R. 2:  Agriculture and Nutrition Act of 2018, As ordered reported by the House Committee on Agriculture on April 18, 2018, Congressional Budget Office (May 2018): https://www.cbo.gov/system/files/115th-congress-2017-2018/costestimate/hr2_1.pdf

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  17. A majority (76%) of survey respondents in Michigan were aware that some services have no copays, in contrast to other questions about knowledge of cost-sharing features of their coverage.

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