Medicaid Work Requirement Will Hurt Kentucky’s Workers


Kentucky’s recently-approved requirement that people work 80 hours a month or lose Medicaid will almost certainly cause many working people to lose coverage, according to a new report by the Washington, D.C.-based Center on Budget and Policy Priorities (CBPP). The report finds that nearly half (46 percent) of low-income workers would be at risk of losing coverage nationally under requirements like Kentucky’s.

Most non-elderly adult Medicaid enrollees in Kentucky work, but in jobs in industries like food service, construction, retail, home health and child care. These jobs generally don’t offer health insurance and employment is often inconsistent. Hours can fluctuate dramatically from one week to the next, employees who want full-time work may only get part-time hours, and job loss is common especially in parts of Kentucky that still have not fully recovered from the Great Recession. Furthermore, a lack of flexibility and benefits like paid sick leave in many of these jobs make it harder to maintain employment, and low wages make it difficult to afford reliable transportation, child care and stable housing needed to stay employed. As a result, many low-wage workers would fall short of Kentucky’s 80-hour-per-month requirement in one or more months during the year.

Even among people working 1,000 hours over the course of the year — or about 80 hours per month, meeting Kentucky’s standard on average — 1 in 4 (25 percent) would be at risk of losing coverage for 1 or more months because they would not meet the 80 hour requirement in every month.

“We’ve been told that the goal of this policy is not to kick people off Medicaid, but that is exactly what it will do,” said Kentucky Center for Economic Policy analyst Dustin Pugel. “In fact, this new report provides yet more evidence that our work requirement will strip health coverage and care from many working Kentuckians and hurt local economies along the way.”

Loss of coverage will lead to poorer health among these workers, especially those with chronic conditions and other health challenges and may make it harder for some people to continue working without care.

“Taking away health coverage will make these workers less healthy, likely setting off a vicious cycle that makes it harder to work,” said Kentucky Voices for Health Executive Director Emily Beauregard. “If we really want to help people succeed in today’s economy, Kentucky should help workers get the skills they need for better-paying jobs, improve access to quality, affordable child care and transportation — and let people keep the health coverage they need to stay healthy.”

In addition to putting coverage at risk for workers with volatile hours and unstable jobs, work requirement policies will also burden workers with new red tape. Workers will have to submit pay stubs, timesheets and other paperwork to prove they worked 80 hours in a given month. Paperwork mistakes — whether by the worker, the employer or the state agency — will lead to coverage losses.

“This proposal is out of touch with the reality of what it’s like to be a low-wage worker in today’s economy,” said Pugel. “The last thing we should do is punish workers who are striving to make ends meet by taking away their health care.”

To read CBPP’s report, click here.

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