Policies for Medicaid Community Involvement and the Benefits of Employment
The new Medicaid Community Engagement Rules, set to take effect in 2026, will require able-bodied adults (ages 19-64) to complete at least 80 hours of work, community service, volunteering, education, or similar activities per month to maintain their Medicaid eligibility. These rules have certain exemptions for parents or caretakers of children under 13, pregnant or postpartum women, individuals who are medically frail, and others.
In 2024, work was shown to play a significant role in the health and well-being of adults. It accounted for 11 percent of total federal Medicaid spending for working-age adults. This spending was concentrated in a few states, with California and New York costing federal taxpayers $13.5 billion and $6.4 billion, respectively.
Half of working-age adults on Medicaid worked 20 hours or fewer per week in 2024. Among those without children, 44 percent worked less than 20 hours per week, with 88 percent of this group not working at all.
The benefits of work extend beyond the adults themselves. It contributes to the physical and mental health of children of adults. Work may potentially increase longevity for both adults and their children.
In 2024, federal taxpayers spent $56.1 billion on Medicaid for childless, working-age, able-bodied adults working 20 hours a week or less. This spending was a significant portion of total federal Medicaid spending in 2024.
Past reforms that linked eligibility for social welfare programs to working have been successful in promoting working, private health insurance coverage, household income, financial stability, financial independence, and stronger families. However, research shows that Medicaid work/community engagement requirements do not significantly increase employment rates. Instead, these requirements tend to reduce Medicaid enrollment and increase the number of uninsured.
The new Medicaid community engagement rules are expected to reduce federal Medicaid spending substantially. However, they also raise administrative burdens and risk increased uninsurance without clear evidence of improving employment.
References:
- Kaiser Family Foundation
- Centre on Budget and Policy Priorities
- Henry J. Kaiser Family Foundation
- Medicaid.gov
- U.S. Department of Health and Human Services
- To improve overall health and wellness, fitness and exercise, mental health, and workplace wellness are crucial factors, but financial stability and personal finance can also significantly impact an individual's well-being.
- The new Medicaid Community Engagement Rules, set to take effect in 2026, aim to encourage employment among able-bodied adults, yet existing research indicates that these requirements may instead increase the number of uninsured rather than significantly increasing employment rates.
- In an attempt to balance the budget and manage Medicaid expenditures, Medicaid Community Engagement Rules will mandate activities for able-bodied adults aged 19-64 to maintain eligibility, offering exemptions for certain groups like parents or caretakers, pregnant women, and the medically frail.
- A study released in 2024 found that a substantial portion of federal Medicaid spending went towards childless, working-age, able-bodied adults who worked less than 20 hours per week. This spending will likely diversify under the new community engagement rules, as those who do not meet the work requirement may lose their Medicaid coverage.
