Working Medicaid Enrollees Value Work But Are Wary About Work Requirements When Told About Paperwork Burden

Copy link to quick take

Nearly two-thirds of adults under 65 covered by Medicaid are working, and while Medicaid work requirements have received a lot of attention in discussions of the “One Big Beautiful Bill,” very few polls have looked at how this group views these requirements and how they may be impacted by them. Many Medicaid enrollees who are currently working support the value of a work requirement, but they don’t want to lose their coverage.

In the latest KFF tracking poll, about half (53%) of Medicaid enrollees under age 65 who are currently working say they support Medicaid work requirements as described in the House bill. Yet support drops to a quarter once they hear some of the trade-offs with imposing such a requirement including the fact that it could put people at risk of losing coverage due to the difficulty documenting their work hours, similar to what happened when Arkansas implemented work requirements during the first Trump administration.

While many working Medicaid enrollees would meet the work hours requirements, many would likely lose their coverage due to the reporting requirements. This may be due to lack of awareness, confusing or complex processes to report, lack of assistance or support to navigate new requirements, limited access to broadband or computers to upload necessary documentation. Our polling finds that most of Medicaid’s working population say losing their coverage would have direct consequences for their financial and personal well-being. The vast majority say losing Medicaid would have an impact on their quality of life (92%), their physical health (92%), their financial health (91%), and their mental health (80%) – including more than half who say it would have a “major impact” in each of these areas. In addition, nearly nine in ten say it would be difficult for them to afford their prescriptions medications (88%) or see a health care provider when they needed to (84%). And notably, eight in ten say it would be difficult for them to get and pay for another form of health insurance if they lost their Medicaid coverage including half who say it would be “very difficult.”

While Congress is still working on the final details of the legislation, some version of Medicaid work requirements will likely be included. And while many people currently working and receiving Medicaid might meet the work criteria, they could lose coverage because of reporting (administrative or paperwork) requirements that could result in severe consequences for health, finances and quality of life.