As the Trump administration eyes reductions to federal spending, the impact of Medicaid work requirements is again a topic in the health policy arena.
Proponents of instituting work requirements argue that Medicaid should serve as a path out of poverty for people enrolled in the program and should encourage them to secure employment. However, a new analysis from KFF notes that most people with Medicaid coverage are currently working.
In 2023, 44% of Medicaid enrollees under the age of 65 were employed full-time, according to the report. An additional 20% were working part-time.
Just 8% of enrollees were unemployed because they were retired, unable to find work or for other reasons. Ten percent were not working because of an illness or disability, while 12% were unemployed because they were serving as a caregiver.
Seven percent were not working because they were in school, according to the report.
"Work requirements in Medicaid have resurfaced as part of a broader legislative package of potential changes to Medicaid designed to significantly reduce federal Medicaid spending," the researchers wrote.
The study found that people who are in better health and with higher levels of education were more likely to be working while enrolled in Medicaid. Seventy percent of people who were in "excellent health" were working, as were 65% of people who were in "good health."
Of people who were working part-time, 22% said it was due to personal or family obligations, while 16% sad it was for the shorter work week. Fourteen percent said they were only working part-time as they were also in school or another training program, and 12% cited slack work or business conditions.
For people who were working, just under half (46%) were employed by small businesses with 50 or fewer employees where they were not eligible for insurance through their work. Companies of this size are not subject to penalties under the Affordable Care Act for not offering coverage.