White House report says 'timing is ideal' for Medicaid work requirements

A report from the White House’s Council of Economic Advisers (CEA) urges Congress to take legislative action to promote work requirements for non-disabled working-age adults in the Medicaid program.

The report comes after President Donald Trump signed an executive order in April instructing agencies to reform welfare programs by encouraging work requirements. CMS announced in January it would allow states to submit Medicaid waivers imposing such requirements and was met with backlash.

CEA estimated 17.2 million adult Medicaid recipients could be subject to work requirements, and most are currently working very few hours per week.

Critics claim the requirements would put millions of Americans at risk of losing critical healthcare benefits. Medicaid provides health insurance coverage to 70 million Americans.

So far, three states—Arkansas, New Hampshire and Indiana—have implemented Medicaid work requirement programs, as CMS evaluates if such programs can improve health outcomes and upward mobility out of poverty. Kentucky, which was the first state to submit a waiver for Medicaid work requirements, recently was blocked from implementing the policy by a federal judge.

CEA’s report, which looked at the impact of work requirements across Medicaid, the Supplemental Nutrition Assistance Program (SNAP) and rental housing assistance programs, argued the “timing is ideal” to expand these types of requirements for non-disabled working-age adults in social welfare programs.

Legislative changes enabling work requirements would represent a major shift and affect a large share of adult beneficiaries.

Among the Medicaid population, 60 percent worked fewer than 20 hours per week, according to the report, while non-disabled working-age adults made up 61 percent of the Medicaid population.

CEA also stated that the “benefit cliff”—the income threshold that eliminates Medicaid beneficiary eligibility—creates a “strong disincentive to work" for households with low incomes.