Understanding the Intersection of Medicaid and Work: What Does the Data Say?

Issue Brief
  1. As of July, 2019, an appeal was underway in the DC Circuit after a federal trial court stopped implementation of Arkansas’s work and reporting requirements in March 2019 and prohibited Kentucky’s waiver from going into effect in April as planned. On July 29, 2019, the court set aside the Granite Advantage Health Care Program demonstration, approved by CMS on Nov. 30, 2018. Implementation of the work requirement and the elimination of retroactive eligibility is stopped unless and until HHS issues a new approval that passes legal muster or prevails on appeal. Previously, on July 8, 2019, NH enacted legislation that allowed for the suspension of the work requirement’s implementation up to but not after July 1, 2021, and suspended the work requirement through Sept. 30, 2019.

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  2. Harold F. O’Neil, Jr., ed. Work Readiness: Competencies and Assessment. (New York: Psychology Press), 2014.

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  3. Hope Clark, et al. Work Readiness Standards and Benchmarks: The Key to Differentiating America’s Workforce and Regaining Global Competitiveness. (Iowa City, IA: ACT), 2013; available at: http://www.act.org/content/dam/act/unsecured/documents/Work-Readiness-Standards-and-Benchmarks.pdf

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  4. Full-time workers include people working 35 hours or more, those who worked 1-34 hours for noneconomic reasons (e.g., illness) and usually work full-time, and people "with a job but not at work" who usually work full- time. People working full time may work at more than one job.

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  5. Kaiser Family Foundation analysis of 2017 National Health Interview Survey (NHIS).

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  6. Kaiser Family Foundation analysis of 2017 National Health Interview Survey (NHIS).

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  7. U.S. Department of Labor, Minimum Wage, https://www.dol.gov/general/topic/wages/minimumwage.

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  8. Tricia Brooks, Lauren Roygardner, and Samantha Artiga, “Medicaid and CHIP Eligibility, Enrollment, and Cost Sharing Policies as of January 2019: Findings from a 50-State Survey,” (Washington, DC: Kaiser Family Foundation, March 2019), https://www.kff.org/medicaid/report/medicaid-and-chip-eligibility-enrollment-and-cost-sharing-policies-as-of-january-2019-findings-from-a-50-state-survey/.

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  9. Rachel Garfield, Kendal Orgera, and Anthony Damico, “The Coverage Gap: Uninsured Poor Adults in States that Do Not Expand Medicaid,” (Washington, DC: Kaiser Family Foundation, March 2019), https://www.kff.org/medicaid/issue-brief/the-coverage-gap-uninsured-poor-adults-in-states-that-do-not-expand-medicaid/.

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  10. Kaiser Family Foundation analysis of 2018 CPS ASEC.

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  11. Kaiser Family Foundation analysis of 2017 National Health Interview Survey (NHIS).

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  12. Kaiser Family Foundation analysis of Outgoing Rotation Group data in 2018 Current Population Survey

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  13. Kaiser Family Foundation analysis of 2018 CPS ASEC.

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  14. Includes people who have at least two of the following chronic conditions: Hypertension, High Cholesterol, Coronary Heart Disease, Angina, Myocardial Infarction, Heart Condition, Stroke, Emphysema, COPD, Asthma, Cancer, Diabetes, Arthritis.

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  15. Kaiser Family Foundation analysis of 2017 National Health Interview Survey (NHIS).

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  16. Kaiser Family Foundation analysis of 2017 National Health Interview Survey (NHIS).

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  17. Based on respondents saying they feel depressed daily, weekly, or monthly.

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  18. Kaiser Family Foundation analysis of 2017 National Health Interview Survey (NHIS).

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  19. Question asks “How often do you use a computer?” and does not specify whether or not to include handheld devices such as smart phones.

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  20. Based on questions asking “Do you use the Internet” and “How often do you use the Internet”. Questions do not specify whether or not to include internet use on handheld devices such as smart phones.

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  21. Based on questions asking “Do you send or receive emails” and “How often do you check this account”. Questions do not specify whether or not to include email use on handheld devices such as smart phones.

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  22. MaryBeth Musumeci, Robin Rudowitz, and Barbara Lyons, “Medicaid Work Requirements in Arkansas: Experience and Perspectives of Enrollees,” (Washington, DC: Kaiser Family Foundation, December 2018), https://www.kff.org/medicaid/issue-brief/medicaid-work-requirements-in-arkansas-experience-and-perspectives-of-enrollees/.

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  23. MaryBeth Musumeci, “Disability and Technical Issues Were Key Barriers to Meeting Arkansas’ Medicaid Work and Reporting Requirements in 2018,” (Washington, DC: Kaiser Family Foundation, June 2019), https://www.kff.org/medicaid/issue-brief/disability-and-technical-issues-were-key-barriers-to-meeting-arkansas-medicaid-work-and-reporting-requirements-in-2018/.

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  24. MaryBeth Musumeci, “Medicaid Enrollees and Work Requirements: Lessons From the TANF Experience,” (Washington, DC: Kaiser Family Foundation, August 2017), https://www.kff.org/medicaid/issue-brief/medicaid-enrollees-and-work-requirements-lessons-from-the-tanf-experience/.

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  25. United States. “A Budget for a Better America, Fiscal Year 2020.” Budget of the U.S. Government. (Washington, DC: United States Government, March 2019), https://www.whitehouse.gov/wp-content/uploads/2019/03/budget-fy2020.pdf.

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  26. MaryBeth Musumeci, Robin Rudowitz, and Barbara Lyons, “Medicaid Work Requirements in Arkansas: Experience and Perspectives of Enrollees,” (Washington, DC: Kaiser Family Foundation, December 2018), https://www.kff.org/medicaid/issue-brief/medicaid-work-requirements-in-arkansas-experience-and-perspectives-of-enrollees/.

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  27. Benjamin D. Sommers, Anna L. Goldman, Robert J. Blendon, E. John Orav, and Arnold M. Epstein, “Medicaid Work Requirements – Results from the First Year in Arkansas,” (New England Journal of Medicine, June 19, 2019), doi: 10.1056/NEJMsr1901772, https://www.nejm.org/doi/full/10.1056/NEJMsr1901772.

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  28. Arizona Health Care Cost Containment System (AHCCCS), State Medicaid Advisory Committee (SMAC), Slide 15: “AHCCCS Works Geographic Phase-in Recommendation,” available at: https://www.azahcccs.gov/AHCCCS/Downloads/SMAC/agendas/SMACAgenda07112019.pdf#page=58.

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