Research Update: Can Parents in Non-Expansion States Meet a Work Requirement and Remain Medicaid-Eligible?

This week, I am reading a study examining Medicaid work requirements in non-expansion states. My colleague, Joan Alker, recently wrote about Mississippi’s waiver request, which is currently up for public comment and includes a work requirement targeted at very poor parents and caretaker relatives with household incomes below 27% FPL. A new study examines whether it is even possible for parents in non-expansion states to meet both a state’s income eligibility threshold and a potential work requirement.

Community Catalyst’s “Work Requirements: A One-Way Ticket to the Coverage Gap

The authors use the Medicaid income eligibility threshold for parents and the minimum wage in non-expansion states to calculate the number of hours parents could work before losing Medicaid eligibility.

What it finds

  • The authors examined households of four with two income-earners (for example, a household with two parents and two children).  They find only three states–South Carolina, Tennessee and Wisconsin—where both parents could work 20 hours per week and remain eligible for Medicaid. A state-by-state table on these findings from the report is below.
  • The authors also conducted the analysis for a household of two with a single income earner and found that parents in six states would remain eligible for Medicaid while working 20 hours per week: Nebraska, South Carolina, Tennessee, Utah, Wisconsin and Wyoming.

Why it matters

  • Work requirements in non-expansion states would likely lead to coverage losses for parents as they become ineligible for Medicaid and do not have other coverage options. Individuals with household incomes below 100% FPL are not eligible for financial assistance for marketplace coverage and are less likely to have employer sponsored insurance through work.
  • Medicaid coverage losses for parents could hurt children, as research shows the two are linked.

Work Requirements: A One-Way Ticket to the Coverage Gap

Note: For the complete table and related notes, see Community Catalyst’s “Work Requirements: A One-Way Ticket to the Coverage Gap”.

Thank you to Dulce Gonzalez at the Center for Children and Families for her assistance on this blog post.

Karina Wagnerman
Karina Wagnerman is a Senior Health Policy Analyst at the Center for Children and Families