Medicaid helps keep Missourians and their families healthy, so they can work, succeed in school and contribute to their community. But Congress is considering several changes to Medicaid that would result in cuts to health services, including a proposal that would require states to implement work requirements.
While most people who get their health insurance through Medicaid already work, work requirements impose administrative barriers and red tape that cause people to lose their coverage – including those who are supposed to be exempt from the requirements in the first place.
In Missouri, work requirements would likely cause more than 111,000 Missourians to lose their health coverage and strain already maxed out eligibility and enrollment systems, affecting all Missourians covered by Medicaid.
Even Missourians Who Are Working or Exempt Would Lose
Coverage
Approximately 90 percent of all working age adults enrolled in Medicaid are already working or may qualify for an exemption due to a disability, caregiving, or enrollment as a student.
Verifying work activities and exemptions simply adds unnecessary bureaucratic red tape for enrollees AND states.
• Other states that have implemented work requirements have found that a large share of those subject to the requirements either lost coverage or were slated to lose it when the policy was put on hold by lawmakers or the courts. Those losing coverage included many people who were working or should have been eligible for exemptions.
• Work requirements would most likely be applied to adults between the ages of 19 and 64 who qualify for Medicaid through Medicaid expansion or as parents. Depending on the specifics, based on the experiences of other states, between 111,250 – 178,000 Missourians could lose their health insurance – even if they’re working or otherwise exempt.
Work Requirements Would Strain An Already Struggling Enrollment System
Work requirements create a new administrative burden for state Medicaid programs, requiring more staff, system upgrades, additional processes, education and outreach to beneficiaries.
Missouri’s enrollment and eligibility systems and staff are already stretched and have a history of problems with eligibility and enrollment, including loss of coverage among eligible individuals due to paperwork errors or red tape.
• The federal government and the courts have already been forced to intervene several times to address violations related to long application processing & call center wait times and wrongful denials among other problems.
• The states that have previously implemented work requirements have proven that the new administrative burden resulted in large numbers of people losing coverage – even though they are eligible and meeting requirements. Rather, it was the barriers to reporting, including long wait times for call center assistance, glitches/crashes in online systems, and not enough staffing in place to handle problems, that have led to people losing coverage erroneously.
Given Missouri’s existing and ongoing issues, work reporting requirements would likely overwhelm Missouri’s Medicaid systems and staff. This would affect all MO HealthNet beneficiaries and result in children, older adults, people with disabilities, and working Missourians losing their coverage.
Conclusion
To be clear, the federal revenue savings projected from work requirements are not because people find jobs or get their health insurance elsewhere – it is because people lose their health coverage due to administrative burdens and red tape. This makes it more difficult for those Missourians to continue working and raises costs for other Missourians.
