California faces the biggest potential coverage losses if federal Medicaid work requirements are enacted, according to an April 14 analysis from the Urban Institute.
About five million adults nationwide could lose Medicaid coverage next year under a federal work requirement for adults ages 19 to 55 living in a Medicaid expansion state. At least 10,000 adults would lose coverage in nearly every expansion state, with the most populated states seeing the largest losses.
Coverage losses would likely result from low awareness or confusion about the new policy, not because Medicaid enrollees are not working. Coverage losses could also vary widely based on the final policy and how individual states administer work requirements.
The researchers analyzed a policy proposal that entails withholding federal funds for adult enrollees in Medicaid expansion states who do not report working for at least 80 hours per month or meet exemption criteria, such as being a student, family caregiver, or having a disability. Several states have proposed similar legislation this year.
States ranked by potential coverage losses under Medicaid work requirements:
California: 1 to 1.2 million
New York: 743,000 to 846,000
Illinois: 193,000 to 220,000
Pennsylvania: 174,000 to 198,000
North Carolina: 171,000 to 195,000
Arizona: 166,000 to 189,000
Ohio: 158,000 to 180,000
Michigan: 145,000 to 165,000
Washington: 121,000 to 138,000
Kentucky: 120,000 to 136,000
Louisiana: 116,000 to 132,000
New Jersey: 115,000 to 131,000
Indiana: 102,000 to 116,000
Virginia: 98,000 to 111,000
Maryland: 95,000 to 109,000
Colorado: 95,000 to 108,000
Massachusetts: 86,000 to 98,000
Oregon: 83,000 to 95,000
New Mexico: 75,000 to 86,000
Connecticut: 74,000 to 85,000
Missouri: 69,000 to 78,000
Minnesota: 67,000 to 76,000
Arkansas: 62,000 to 70,000
Nevada: 59,000 to 67,000
Oklahoma: 47,000 to 53,000
West Virginia: 38,000 to 44,000
Iowa: 34,000 to 39,000
District of Columbia: 26,000 to 30,000
Rhode Island: 25,000 to 29,000
Hawaii: 24,000 to 27,000
Montana: 23,000 to 27,000
Utah: 20,000 to 23,000
Idaho: 17,000 to 20,000
Delaware: 17,000 to 20,000
New Hampshire: 17,000 to 19,000
Nebraska: 13,000 to 15,000
Maine: 11,000 to 13,000
Alaska: 10,000 to 11,000
South Dakota: 8,000 to 9,000
Vermont: 7,000 to 8,000
North Dakota: 5,000 to 6,000
