Study Confirms GOP Medicaid Work Requirements Succeeded in Taking Away People's Healthcare, But Did Nothing to Boost Employment

The first major study of new Medicaid work requirements confirmed that the warnings of critics were correct: requiring program recipients to work serves only to take healthcare away from vulnerable communities, while doing nothing to promote employment.

Researchers at the Harvard T.H. Chan School of Public Health released a report Wednesday on the work requirements, which went into effect in Arkansas in 2018. One of President Donald Trump’s signature healthcare policies, the program demanded that Medicaid recipients work at least 80 hours per month or participate in job training, or risk losing their health insurance.

The program, which is now on hold following a federal judge’s decision in March, resulted in nearly 20,000 low-income Arkansas residents losing their health coverage.

“Medicaid work requirements don’t cause anybody to get work; they just lose their insurance. Which since the GOP is the party of ‘Cruelty is the Point,’ means the policy is working.” —Scott Lemieux, bloggerThe share of adults between the ages of 30 and 49 who had Medicaid coverage fell from 70.5 percent to 63.7 percent after the requirements were implemented, contributing to a four percent increase in the uninsured rate in the state.

The employment rate went down four percent over the same period, and the Harvard researchers found that “the population targeted by Arkansas’ work requirement saw significantly more deterioration than other age groups and people in other states,” Dylan Scott reported at Vox.

Policy experts who had warned against implementing work requirements wrote that the findings and their implications for poor Americans were troubling but unsurprising.

“Some (including me) have long suspected that the Trump administration’s signature Medicaid initiative—the promotion of work reporting requirements—is not about supporting better economic or health outcomes for low-income people, but rather about perpetuating inaccurate stigmas and taking away health insurance from those who rely on Medicaid to cut costs,” wrote Joan Alker, executive director of Georgetown University’s Center for Children and Families. “These new findings offer cold validation for these suspicions.”

Political science professor and writer Scott Lemieux wrote on Twitter that while Arkansas’s work requirements appear to have failed in reaching the Trump adminsitration’s stated goal, they have actually succeeded in further marginalizing and harming some of the poorest Americans.

“Medicaid work requirements don’t cause anybody to get work; they just lose their insurance. Which since the GOP is the party of ‘Cruelty is the Point,’ means the policy is working,” wrote Lemieux.


The Republican Party has long claimed that offering Medicaid coverage, SNAP benefits, and other government to people who are not employed “trap[s] people on government programs,” and discourages them from finding work, as Medicaid and Medicare administrator Seema Verma said before Arkansas adopted the rules.

As Sen. Bernie Sanders (I-Vt.) wrote on Twitter, “If the GOP wants to help people find work, they should invest in employment programs and guarantee health care as a right—not punish people who are struggling.”

Harvard’s study, published in the New England Journal of Medicine, also revealed that a lack of transparency surrounding the requirements caused major confusion in Arkansas and resulted in many Medicaid recipients being kicked off the rolls despite the fact that they were already working.

More than 95 percent of Medicaid recipients were already working or were eligible for an exemption due to disabilities or other factors, but about a third of them had not heard of the requirements and didn’t know they had to report their working hours in order to keep their coverage.

However, the grassroots group Progress Michigan wrote, the key to solving the problem of work requirements isn’t to simply clarify them or attempt to improve them.

“The fact of the matter is that Medicaid work requirements are a cruel scam designed to rip health care away from low-income folks under the guise of saving a few bucks,” wrote the group.

“It’s time for our elected officials to stop trying to make a bad law more palatable and recognize the one change that would actually fix the many problems with Medicaid work requirements: Getting rid of them once and for all.”

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