Hefei Wen, PhDAssistant Professor, Department of Health Management & PolicyUniversity of Kentucky College of Public Health

Medicaid Work Requirements Disproportionately Affect Those with Mental Health or Substance Use Disorders

MedicalResearch.com Interview with:

Hefei Wen, PhDAssistant Professor, Department of Health Management & PolicyUniversity of Kentucky College of Public Health

Dr. Wen

Hefei Wen, PhD
Assistant Professor, Department of Health Management & Policy
University of Kentucky College of Public Health

MedicalResearch.com: What is the background for this study?

Response: Work requirements condition Medicaid eligibility on completing a specified number of hours of employment, work search, job training, or community service. Little is known about how behavioral health and other chronic health conditions intersect with employment status among Medicaid enrollees who may be subject to work requirements.

MedicalResearch.com: What are the main findings?

Response: We found that people with behavioral health conditions (including serious mental illness and substance use disorder) and other chronic health conditions were more likely to be enrolled in Medicaid and subject to work requirements than those without any identified health conditions.

Furthermore, among Medicaid enrollees, those with behavioral and other health conditions were also less likely to have worked twenty hours or more in the past week (and thus be more unlikely to meet work requirements).  

MedicalResearch.com: What should readers take away from your report?

Response:Medicaid work requirements disproportionately affect a population that has an elevated prevalence of behavioral health conditions as well as other health conditions.

If work requirements are to be a continued piece of Medicaid policy, it will be crucial that policy changes are also adopted to ensure that Medicaid covers a full continuum of evidence-based behavioral health services and that Medicaid enrollees with work-limiting conditions are given reasonable accommodations and exemptions, as well as adequate assistance to document their compliance with work requirements.  

Any disclosures?

Dr. Brendan Saloner is supported by an early career award from the National Institute on Drug Abuse. 


Behavioral And Other Chronic Conditions Among Adult Medicaid Enrollees: Implications For Work Requirements
Hefei Wen, Brendan Saloner, and Janet R. Cummings
Health Affairs 2019 38:4, 660-667


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Last Updated on April 8, 2019 by Marie Benz MD FAAD