12 Dec Medicaid Work Requirements May Have Unintended Consequences on Costs and Enrollees
MedicalResearch.com Interview with:
Renuka Tipirneni, MD, MSc
Clinical Lecturer in Internal Medicine
University of Michigan Department of Internal Medicine, Division of General Medicine, and
Institute for Healthcare Policy & Innovation
Ann Arbor, MI
MedicalResearch.com: What is the background for this study? What are the main findings?
Response: Several states have submitted proposals to require Medicaid expansion enrollees to work, actively seek work or volunteer, or risk losing Medicaid coverage. The current federal administration has signaled a willingness to approve the waivers states need to enact such requirements.
In our survey of over 4000 Medicaid expansion enrollees in Michigan, we found that nearly half of enrollees have jobs, another 11 percent can’t work, likely due to serious physical or mental health conditions, and another 27% are out of work but also are much more likely to be in poor health.
MedicalResearch.com: What should clinicians and patients take away from your report?
Response: Our survey shows that work requirements in Medicaid would likely only apply to a small group of enrollees. States considering work requirements should evaluate their potential impact on individuals, and the potential return on the cost of enforcement.
We also found that those Medicaid expansion enrollees who aren’t working face significant health challenges that may prevent them from working. Dropping them from coverage for failure to fulfill a work requirement could significantly disrupt their ability to manage chronic health conditions that can worsen without treatment.
MedicalResearch.com: What recommendations do you have for future research as a result of this study?
Response: Future research should examine how Medicaid coverage may impact people’s health and ability to work or seek a job.
MedicalResearch.com: Is there anything else you would like to add?
Response: This is the first peer-reviewed study from the University of Michigan Institute for Healthcare Policy & Innovation’s (IHPI) formal evaluation of Michigan’s Medicaid expansion, called the Healthy Michigan Plan. The evaluation, funded by IHPI’s contract with the Michigan Department of Health and Human Services, is required under a federal waiver that allowed the state to customize its Medicaid expansion when it launched in April 2014.
MedicalResearch.com: Thank you for your contribution to the MedicalResearch.com community.
Renuka Tipirneni, Susan D. Goold, John Z. Ayanian. Employment Status and Health Characteristics of Adults With Expanded Medicaid Coverage in Michigan. JAMA Intern Med. Published online December 11, 2017. doi:10.1001/jamainternmed.2017.7055
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