Medicaid Work Requirements Must Include Reasonable Accommodations and Exemptions

April 03, 2019


“If work requirements are to be a continued piece of Medicaid policy, policy changes must also be adopted to ensure that Medicaid covers a full continuum of evidence-based behavioral health services and that Medicaid enrollees with work-limiting conditions are given reasonable accommodations and exemptions." 


That's the conclusion of a new study from the University of Kentucky College of Public Health, examining the impact of behavioral and chronic conditions on individuals subject to Medicaid work requirements.


Dr. Hefei Wen, assistant professor of Health Management and Policy at the University of Kentucky College of Public Health, is the first and corresponding author of “Behavioral And Other Chronic Conditions Among Adult Medicaid Enrollees: Implications For Work Requirements” published in Health Affairs. Co-authors are Dr. Brendan Saloner, Johns Hopkins Bloomberg School of Public Health, and Dr. Janet R. Cummings, Emory University Rollins School of Public Health.


Medicaid work requirements condition health insurance eligibility on completing a specified number of hours of employment, work search, job training, or community service. To date, little has been known about how behavioral health and other chronic health conditions intersect with employment status among Medicaid enrollees who may be subject to work requirements.


The researchers’ findings suggest that people who may be subject to the requirements have an elevated prevalence of behavioral and other chronic health conditions. Using data from the National Survey on Drug Use and Health for the period 2014–16, investigators found that people with behavioral health and other chronic health conditions were more likely to be enrolled in Medicaid and subject to work requirements than those without any identified health conditions. Furthermore, among Medicaid enrollees, those with behavioral and other health conditions were also less likely to have worked twenty hours or more in the past week (and thus less likely to meet work requirements).



The University of Kentucky College of Public Health is a catalyst of positive change for population health, with a mission to develop health champions, conduct multidisciplinary and applied research, and collaborate with partners to improve health in Kentucky and beyond.