Medicaid work requirements would have 'negligible effect on employment,' CBO says

The Congressional Budget Office said a proposal to add work requirements for Medicaid eligibility would have "a negligible effect on employment status or hours worked by people who would be subject to the work requirements."

House Republicans included the work requirement proposal in a bill to raise the debt ceiling into next year.

The CBO's estimates were included in an April 26 letter to Rep. Frank Pallone Jr., in response to the New Jersey Democrat's request for information about the budgetary effects of the proposed requirement. 

CBO said evidence on the effectiveness of Medicaid work requirements is limited to Arkansas, the only state where such requirements were established for more than a few months. The state established requirements for some childless adults for part of 2018 and 2019. 

"According to reports on the program, a large percentage of affected adults either met the requirement or qualified for an exemption," CBO said in the letter. "Most of the remaining group lost their Medicaid coverage because they did not meet the work requirement."

Citing a 2019 study, CBO said neither employment nor the number of hours worked increased, "although the evidence is scant."

Under House Republicans' proposal, Medicaid beneficiaries must work, volunteer or be part of a work program for 80 hours per month or participate in some combination of those activities. Those rules would affect beneficiaries ages 19 to 56. It includes exceptions for pregnant women, parents and caregivers, as well as those who are physically or mentally unable to work, as determined by a physician. The CBO estimated that 600,000 people would lose coverage if the requirement takes effect. The proposal is not expected to pass the Democratic-controlled Senate, however. 

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