Common Dreams - Here's Why We Know Work Requirements for Medicaid Don't Work

And let's not forget how cruel they are.

Laura Harker
Dec 21, 2024

As Republicans at the federal level prepare to take over majorities in both the House and Senate, some have proposed deeply damaging cuts to Medicaid, including taking health coverage away from people who don’t meet unnecessary and burdensome work requirements. Some state policymakers are interested in pursuing Medicaid work requirements as well. But a Georgia Medicaid program provides the latest evidence that work requirements are the worst sort of red tape — blocking health coverage for working people, people with serious health conditions, and people with disabilities.

Georgia is one of ten states that has not adopted the Affordable Care Act’s Medicaid expansion provision, instead applying for a waiver to provide Medicaid to certain low-income adults, conditioned on meeting work requirements. This waiver program, called Pathways to Coverage, requires adults with low incomes to report at least 80 hours of work or volunteer activities each month as a condition of getting and keeping their coverage. It is available to adults up to 100 percent of poverty, or $15,060 annually for an individual.

The results from over one year of Pathways to Coverage are in:

-About 5,500 people were covered as of November 2024, far less than the 110,000 who initially expressed interest, and well under the about 240,000 uninsured people estimated to potentially be eligible for Pathways.

-Application backlogs, excessive paperwork, and complex rules have left people waiting for coverage after they’ve applied and kept many other people from even applying for the program.

-Spending on administrative changes, such as systems updates, eclipsed spending on health care services and offered little return on investment in facilitating enrollment.

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