CPSD’s two-pager: Medicaid Cuts Hurt Workforce Participation

Overview

Medicaid provides services that help disabled people work. Medicaid cuts will restrict the 15 million disabled people enrolled in Medicaid from obtaining the services they need to be gainfully employed.
People in better health work more than people in fair health. Medicaid is necessary to improve people’s health, so Medicaid cuts will likely impair many enrollees to the point of unemployment.
Nearly two-thirds of Medicaid covered adults under 65 are already working full or part time.
More than 75% of Americans, across political party lines, have favorable views of Medicaid.
Medicaid enables enrollees—both those with and without disabilities—to lead independent, self-determined lives.

Majority of working age adults on Medicaid are already working.
Medicaid work requirements force people to choose between keeping their healthcare and keeping their job.
Work requirements do not increase employment rates.
Work requirements are costly to implement and would increase state spending, overwhelmingly on wasteful administration and consulting costs, instead of people’s health. Georgia exemplifies this.
A carve out won’t fix the problem. People with disabilities can’t be carved out of work requirements because disabled people (and their caregivers) are represented in every eligibility pathway. Work requirements harm people with disabilities because it results in fewer disabled people getting the basic healthcare they need in order to work.
The bureaucratic red tape and unnecessary reporting paperwork created by work requirements limit working people’s ability to keep their health care, particularly if they work multiple jobs or experience language and accessibility barriers.
Work requirements will most hurt rural Americans, who already face employment barriers from inadequate transportation assistance, child care, and job training.
Work requirements harm people already struggling to provide for themselves and their families, such as parents, caregivers, and workers in unpredictable jobs.
36 million people are at risk of having health coverage taken away by Medicaid work requirements.

Medicaid’s coverage of HCBS enables people with disabilities to receive the types of services necessary to improve the requisite skills for finding and keeping competitive integrated employment.
HCBS services include job coaches and employment support staff, and also life-saving habilitation support for activities of daily living, like eating, dressing, transportation, and bathing.
Medicaid HCBS are provided through a Medicaid Waiver program, which is optional.
- All 50 states have a waiver for HCBS because of the need for long-term services and supports (LTSS) in the community.
- Medicaid covers nearly 70% of all HCBS and 61% of all LTSS.
Cuts to HCBS eligibility and benefits will have downstream harms to workforce readiness, workforce participation including community-based jobs, and the amount of money people receiving services can contribute to the economy.

Medicaid funding for healthcare workers and DSPs creates more jobs and helps the economy.
- Medicaid cuts mean increased staffing shortages and fewer jobs at nursing homes and hospitals because Medicaid covers over 40% of births and helps pay the costs for almost two-thirds of nursing home residents.
More than 1/10th of Medicaid enrollees aren’t working because they’re family caregivers. Therefore, many more people could be working if their family members got Medicaid coverage for professional caregivers.

“Just one extra year of Medicaid coverage during childhood leads to higher earnings and better productivity as an adult, boosting the nation’s economy.”
Schools are eligible to be reimbursed for qualifying expenses in the provision of medically-necessary services to Medicaid-eligible students.
Cuts to Medicaid undermine the health of the country’s future workforce.

Medicaid buy-in programs, available in 46 states, allow individuals to maintain Medicaid coverage while working. Medicaid buy-in helps incentivize more people to work.
Medicaid buy-in programs allow people with disabilities to work without being forced to choose between their jobs and the care and services they need to maintain their health.