Over 3 in 4 adults potentially subject to Medicaid work requirements may already have a route to exclusion or compliance.

Abstract

Introduction: Starting in 2027, 18.5 million Medicaid enrollees will likely be subject to new work requirements that could lead to significant coverage losses.

Methods: Using American Community Survey data, we estimate the share of the population of interest that will have a route to exclusion from or compliance with the requirements. We also explore how rates of exclusion from or compliance with work requirements vary by state and demographic group.

Results: We find that 46% of those in our proxy population will meet the criteria for at least one exclusion, 58% will meet the criteria for compliance, and 78% will have at least one route to exclusion or compliance. The "exclusion or compliance" share varies from 70% in New York to 94% in North Dakota. It also varies by demographic group, as women and younger adults are more likely than their counterparts to have a route to exclusion or compliance.

Conclusion: The large "exclusion or compliance" share implies that an important driver of coverage loss will be states' capacity to verify exclusions or compliance, as <1 in 4 enrollees are estimated to not have a route to exclusion or compliance.