{"id":657,"date":"2025-04-15T09:00:00","date_gmt":"2025-04-15T09:00:00","guid":{"rendered":"http:\/\/shapegreatness.org\/?p=657"},"modified":"2025-04-18T17:49:27","modified_gmt":"2025-04-18T17:49:27","slug":"states-push-medicaid-work-rules-but-few-programs-help-enrollees-find-jobs","status":"publish","type":"post","link":"http:\/\/shapegreatness.org\/index.php\/2025\/04\/15\/states-push-medicaid-work-rules-but-few-programs-help-enrollees-find-jobs\/","title":{"rendered":"States Push Medicaid Work Rules, but Few Programs Help Enrollees Find Jobs"},"content":{"rendered":"

For many years, Eric Wunderlin\u2019s health issues made it hard to find stable employment.<\/p>\n

Struggling to manage depression and diabetes, Wunderlin worked part-time, minimum-wage retail jobs around Dayton, Ohio, making so little he said he sometimes had to choose between paying rent and buying food.<\/p>\n

But in 2018, his CareSource Medicaid health plan offered him help getting a job. It connected him to a life coach, who helped him find full-time work with health benefits. Now, he works for a nonprofit social service agency, a job he said has given him enough financial stability to plan a European vacation next year.<\/p>\n

\u201cI feel like a real person and I can go do things,\u201d said Wunderlin, 42. \u201cI feel like I pulled myself out of that slump.\u201d<\/p>\n

Republicans in Congress and several states, including Ohio, Iowa, and Montana, are pushing to implement work requirements<\/a> for nondisabled adults, arguing a mandate would encourage enrollees to find jobs. And for Republicans pushing to require Medicaid enrollees to work, Wunderlin\u2019s story could be held up as evidence that government health coverage can help people find employment and, ultimately, reduce their need for public assistance.<\/p>\n

Yet his experience is rare. Medicaid typically does not offer such help, and when states do try to help, such efforts are limited.<\/p>\n

And opponents point out that most Medicaid recipients already have jobs and say such a mandate would only kick eligible people off Medicaid, rather than improve their economic prospects. Nearly two-thirds of Medicaid enrollees work<\/a>, with most of the rest acting as caregivers, going to school, or unable to hold a job due to disability or illness, according to KFF, a health information nonprofit that includes KFF Health News.<\/p>\n

Existing efforts to help Medicaid recipients get a job have seen limited success because there\u2019s not a lot of \u201croom to move the needle,\u201d said Ben Sommers, a professor of health care economics at the Harvard T.H. Chan School of Public Health. Most Medicaid enrollees already work \u2014 just not in jobs with health benefits, he said.<\/p>\n

\u201cThe ongoing argument that some folks make is that there are a lot of people freeloading in Medicaid,\u201d he said. \u201cThat\u2019s just not supported by the evidence.\u201d<\/p>\n

<\/p>\n

Using Health Programs To Encourage Work<\/strong><\/p>\n

The GOP-controlled Congress could allow or require states to implement a Medicaid work requirement as part of revamping and downsizing Medicaid. The first Trump administration encouraged those work mandates, but many were struck down by federal judges who said they were illegal under federal law.<\/p>\n

Policy experts and state officials say more attention should be paid to investments that have helped people find better jobs \u2014 from personalized life coaching to, in some cases, health plans\u2019 directly hiring enrollees.<\/p>\n

They argue work requirements alone are not enough. \u201cThe move to economic mobility requires a ladder, not a stick,\u201d said Farah Khan, a fellow with the Brookings Institution, a nonpartisan think tank.<\/p>\n

While Medicaid work requirements have been debated for decades, the issue has become more heated as 40 states and Washington, D.C., have expanded Medicaid eligibility under the Affordable Care Act to the vast majority of low-income adults. More than 20 million adults<\/a> have gained coverage as a result \u2014 but Republicans are now considering eliminating the billions in extra federal funding that helped states extend eligibility beyond groups including many children, pregnant women, and disabled people.<\/p>\n

Only Georgia and Arkansas have implemented mandates that some Medicaid enrollees work, volunteer, go to school, or enroll in job training. But a study Sommers co-authored<\/a> showed no evidence work requirements in Arkansas\u2019 program led to more people working, in part because most of those who could work already were.<\/p>\n

In Arkansas, more than 18,000 people lost coverage under the state\u2019s requirement before the policy was suspended by a federal judge in 2019 after less than a year. Those who lost their Medicaid health care reported being unaware or confused about how to report work hours. Since 2023, Arkansas has been giving Medicaid health plans financial incentives to help enrollees train for jobs, but so far few have taken advantage.<\/p>\n

Some plans, including Arkansas Blue Cross and Blue Shield\u2019s, offer members $25 to $65 to complete a \u201ccareer readiness\u201d certificate. In 2024, some Arkansas health plans offered enrollees educational videos about topics including taxes and cryptocurrency.<\/p>\n

Health plans don\u2019t have an incentive to help someone find a better-paying job, because that could mean losing a customer if they then make too much to qualify for Medicaid, said Karin VanZant, a vice president at Clearlink Partners, a health care consulting company.<\/p>\n

Rather than offering incentives for providing job training, some states, such as California and Ohio, require the insurance companies that run Medicaid to help enrollees find work.<\/p>\n

In Montana, where some lawmakers are pushing to implement work requirements, a promising optional program nearly collapsed after state lawmakers required it be outsourced to private contractors.<\/p>\n

Within the program\u2019s first three years, the state paired 32,000 Medicaid enrollees with existing federally funded job training programs. Most had higher wages a year after starting training, the state found<\/a>.<\/p>\n

But enrollment has plummeted to just 11 people, according to the latest data provided by the state\u2019s labor department.<\/p>\n

Sarah Swanson, who heads the department, said several of the nonprofit contractors that ran the program shuttered. \u201cThere was no real part in this for us to deliver direct services to the folks that walked through our door,\u201d she said. The state hopes to revive job training by allowing the department to work alongside contractors to reach more people.<\/p>\n

\n\t\tMore from Medicaid Watch\t<\/h4>\n