10 Reasons Work Requirements for Medicaid are Dumb

South Dakota republicans have never met a bad idea they didn’t like.

South Dakota republicans have never met a bad idea they didn’t like. Continuing that tradition State Sen. Casey Crabtree (R) and State Rep. Tony Venhuizen (R) got the legislature to place the question of creating work requirements on the ballot for November 2024.

This amendment would allow for the state legislature to establish work requirements for individuals who are eligible for Medicaid under the expansion of the program that voters approved in 2022, which amended the state constitution to require the state to expand Medicaid to adults between 18 and 65 with incomes below 138% of the federal poverty level. These work requirements would apply to individuals who are not diagnosed as being mentally or physically disabled.

Nationwide, work requirements for Medicaid have been largely withdrawn or invalidated. This policy shift largely occurred under the Biden administration, which does not support Medicaid work requirements as they were previously endorsed during the Trump era. These requirements had been contested and struck down in various states due to concerns that they led to significant losses in coverage without substantially improving employment among beneficiaries.

Additionally, it’s important to note that the implementation of any Medicaid work requirements would require approval from the federal Centers for Medicare and Medicaid Services (CMS). Historically, such proposals have faced significant legal challenges.

1. **Increased Administrative Costs**: Implementing and monitoring work requirements can lead to higher administrative expenses, which may offset any potential savings¹.

2. **Loss of Coverage for Eligible Individuals**: Work requirements can result in eligible beneficiaries losing their coverage due to inability to comply with the requirements or bureaucratic hurdles².

3. **Health Risks**: Those who lose coverage may face increased health risks due to lack of access to necessary medical care¹.

4. **No Significant Impact on Employment**: Studies have shown that work requirements do not significantly increase employment among beneficiaries².

5. **Financial Hardship**: Loss of coverage can lead to financial hardship, as individuals may struggle to pay out-of-pocket for medical care¹².

6. **Ethical Concerns**: There are ethical concerns about denying access to healthcare based on employment status, especially for vulnerable populations¹.

7. **Disproportionate Impact on Marginalized Groups**: Work requirements can disproportionately affect marginalized groups who face barriers to employment, such as those with disabilities or limited education².

8. **Legal Challenges**: Work requirements have faced legal challenges, questioning their legality and ethical implications¹.

9. **Counterproductive Outcomes**: Instead of promoting self-sufficiency, work requirements can create obstacles that hinder individuals’ ability to gain stable employment².

10. **Lack of Support Services**: Without adequate support services like job training or childcare, work requirements may be unrealistic for many individuals².

These reasons highlight the complexities and potential negative consequences of implementing work requirements for Medicare.

(1) The Ethics of Medicaid’s Work Requirements and Other Personal …. https://jamanetwork.com/journals/jama/fullarticle/2681081.
(2) States’ Experiences Confirm Harmful Effects of Medicaid Work Requirements. https://www.cbpp.org/health/states-experiences-confirming-harmful-effects-of-medicaid-work-requirements.
(3) Implications of a Medicaid Work Requirement: National Estimates … – KFF. https://www.kff.org/medicaid/issue-brief/implications-of-a-medicaid-work-requirement-national-estimates-of-potential-coverage-losses/.

10 Reasons Work Requirements for Medicaid are Dumb

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