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

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.