Medicaid Work Requirements Have Mostly Failed. The GOP Is Still Pushing Them.

Republicans are pushing to add Medicaid work requirements to the budget bill they are moving through Congress, saying the provisions are necessary to cut costs and get more low-income Americans back on the job.

State experiments with that approach show its limits.

A short-lived program in Arkansas in 2018 didn’t boost employment among targeted residents, research has shown. The bureaucracy and confusion of the program also resulted in thousands of people losing their Medicaid coverage.

A current Medicaid pilot program in Georgia, meanwhile, has enrolled a fraction of the people the state aimed to register, in part because the monthly reporting requirements to prove employment are so cumbersome, according to doctors and healthcare experts.

“I think you could learn some reasonable lessons from both places,” said Dr. Ben Sommers, a Harvard economist and physician who has studied the state programs and served as a health official in the Biden administration. “Most of the people with Medicaid who can work are working, and there is a lot of confusion and a lot of red tape that goes with these requirements that people have trouble navigating.”

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Trevor Hawkins, an Arkansas lawyer who helped residents navigate the Medicaid program at the time, said the state website for submitting work reports wasn’t mobile-friendly and wouldn’t accept submissions after a certain time of night. People with more than one part-time job and fluctuating schedules—a common occurrence among Medicaid recipients—sometimes struggled to get enough hours or to gather paperwork from several employers to prove their hours, he said.

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Uploading paperwork to the website often fails, according to Laura Colbert, executive director of the nonprofit Georgians for a Healthy Future. “You think you’ve uploaded it, but on the other end they can’t see it,” she said. Local benefits offices have limited hours and staff to help, she added.

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