Skip to main content
Robert Wood Johnson Foundation
  • Our Vision
    • Our Vision Overview
    • Why Health Equity
    • Affirming Diversity, Equity, and Inclusion
    • Focus Areas
    • Measuring RWJF Progress
  • Grants
    • Grants Overview
    • Active Funding Opportunities
    • Awarded Grants
    • Grantee Stories
    • Grant Process
    • Grantee Resources
  • Insights
    • Insights Overview
    • Blog
    • Our Research
    • Advocacy And Policy
  • About RWJF
    • About RWJF Overview
    • Our Guiding Principles
    • How We Work
    • Impact Investments
    • Staff And Trustees
    • Press Room
    • Careers
    • Contact Us
    • Accessibility Statement
Find A Grant
Global Search Dialog
    Robert Wood Johnson Foundation
    • Our Vision
      • Our Vision Overview
      • Why Health Equity
      • Affirming Diversity, Equity, and Inclusion
      • Focus Areas
      • Measuring RWJF Progress
    • Grants
      • Grants Overview
      • Active Funding Opportunities
      • Awarded Grants
      • Grantee Stories
      • Grant Process
      • Grantee Resources
    • Insights
      • Insights Overview
      • Blog
      • Our Research
      • Advocacy And Policy
    • About RWJF
      • About RWJF Overview
      • Our Guiding Principles
      • How We Work
      • Impact Investments
      • Staff And Trustees
      • Press Room
      • Careers
      • Contact Us
      • Accessibility Statement
    Find A Grant
    Global Search Dialog

      Expanding Federal Work Requirements to Age 64 Would Increase Medicaid Coverage Losses

      Research Apr-28-2025 | Karpman M , Haley JM , and Kenney GM | 1-min read
      1. Insights
      2. Our Research
      3. Expanding Federal Work Requirements to Age 64 Would Increase Medicaid Coverage Losses
      Download brief
      Health insurance card.

      More than 6 million people could lose Medicaid coverage in 2026 if Congress enacts a work requirement for adults ages 19 to 64 in states that expanded their Medicaid programs.

      The Issue

      Researchers previously analyzed policy proposals that would withhold federal funding for people enrolled in Medicaid expansion ages 19 to 55 who do not report working, engaging in work-related activities, or meet exemption criteria, such as being a student, family caregiver, or having a disability. This analysis examines the effects of expanding potential work requirements to include adults up to age 64.

       

      Key Findings


       

      • Between 5.5 and 6.3 million adults ages 19 to 64 living in states that expanded Medicaid would lose Medicaid coverage next year under work requirements.
      • Nearly nine in 10 adults ages 19 to 64 with Medicaid expansion coverage already work, are looking for a job, attend school, are caring for family members, are in fair or poor health, or reported having a disability.
        • Researchers say this number could be even higher, as some adults (particularly those ages 56 to 64) could have unreported health conditions that affect their ability to work.

       

      Conclusion 

      Researchers conclude that expanding eligibility criteria for work requirements up to age 64 would increase Medicaid coverage losses. Most people who would lose coverage would do so because of difficulty filling out paperwork, not because they can work and choose not to do so.

      About the Author/Grantee

      The nonprofit Urban Institute is dedicated to elevating the debate on social and economic policy. For nearly five decades, Urban scholars have conducted research and offered evidence-based solutions that improve lives and strengthen communities across a rapidly urbanizing world. Their objective research helps expand opportunities for all, reduce hardship among the most vulnerable, and strengthen the effectiveness of the public sector. Visit the Urban Institute’s Health Policy Center for more information specific to its staff and its recent research.

      • About this Grant

      Related Content

      Library
      Migrant farm workers receive dental care at one of Hudson River Health Care's clinics in Walden, NY.

      Work Requirements

      Work requirements do not move people off assistance and into self-sufficiency; instead they harm health and drive people and families already struggling to make ends meet deeper into poverty. 

      1-min read

      Healthcare Coverage and Access Policy and Law
      Focus Area
      An Ethnic mother and daughter are indoors in a hospital. The daughter is about to have a checkup. Her mother and doctor are trying to comfort her.

      Medicaid

      Medicaid coverage leads to better health outcomes for participants—saving lives, lowering health care costs, making childbirth safer, reducing medical debt, and helping strengthen state economies.

      1-min read

      Healthcare Coverage and Access Policy and Law
      Focus Area
      A medical professional gives a sonogram.

      Healthcare Coverage and Access

      Follow key trends in research on coverage among uninsured individuals, and national and local initiatives to increase enrollment in U.S. health insurance.

      1-min read

      Healthcare Coverage and Access

      Subscribe to receive Funding Alerts & more

      Explore the latest in reflection and research from subject matter experts at RWJF and our wide network of partners.

      Email address already subscribed. Please check your inbox to manage your subscriptions.

      Subscribed!

      Thank you. You are now subscribed.

      Tell us what type of content you want to receive.

      Be informed with our twice a month newsletter updating you with relevant news and research around a Culture of Health, as well as the latest funding opportunities.

      Get funded by RWJF: Receive notifications when new funding opportunities are released.

      Receive monthly updates on RWJF-sponsored research that informs many robust health policy debates on Capitol Hill, covering topics like health equity, improving access to quality healthcare, equitable housing, and more.

      Shop talk for researchers. This monthly newsletter covers research news and opportunities from the Robert Wood Johnson Foundation.

      Communications expedite action. Get periodic research and expert insights on the best ways to communicate so we can spread what works.

      Sometimes we have news, announcements or opportunities that don't quite fit the subscription parameters above. If you're interested, we'll send you this information under "There's more...". *If you've indicated you are an EU resident, we will only send these communications if you intentionally check this box.

      Which profession or pursuit best describes you?

      Area(s) Of Interest

      Unsubscribe

      Stop receiving all emails from RWJF

      This site is protected by reCAPTCHA and the Google Privacy Policy and Terms of Service apply.
      • CONTACT RWJF

        50 College Road East
        Princeton, NJ 08540-6614

         

        US Toll Free: (877) 843-7953

        International: +1 (609) 627-6000

      • MANAGE YOUR GRANTS

        MyRWJF Login

        • Facebook
        • LinkedIn
        • YouTube
        • Instagram

      • Our Vision
        • Our Vision Overview
        • Why Health Equity
        • Affirming Diversity, Equity, and Inclusion
        • Focus Areas
        • Measuring RWJF Progress
      • Grants
        • Grants Overview
        • Active Funding Opportunities
        • Awarded Grants
        • Grantee Stories
        • Grant Process
        • Grantee Resources
      • Insights
        • Insights Overview
        • Blog
        • Our Research
        • Advocacy And Policy
      • About RWJF
        • About RWJF Overview
        • Our Guiding Principles
        • How We Work
        • Impact Investments
        • Staff And Trustees
        • Press Room
        • Careers
        • Contact Us
        • Accessibility Statement

      ©2001- 

      Robert Wood Johnson Foundation. All Rights Reserved. 

       

      • Manage Email
      • Privacy Statement
      • Terms and Conditions