The bill would require certain Medicaid recipients to work, volunteer, or participate in a work program for at least 80 hours a month to maintain eligibility.
Aaron Bean
Representative
FL-4
This bill amends the Social Security Act to require certain adults on Medicaid to complete 80 hours per month of work, community service, or a work program to maintain eligibility. Federal funding to states would be denied for those who do not meet this "community engagement requirement" for at least 3 months of the year. Certain individuals, such as those under 18 or over 65, pregnant individuals, and those with disabilities, are exempt from this requirement. States have the option to disenroll individuals if federal funding is unavailable due to non-compliance.
Medicaid Overhaul Ties Benefits to 80-Hour Monthly Work or Service Rule: States Can Drop Coverage for Non-Compliance
This bill wants to change the rules for some adults on Medicaid. It's adding a 'community engagement requirement,' which basically means working or volunteering for at least 80 hours every month. If people don't meet this requirement, the federal government won't pay for their healthcare, and states can kick them off Medicaid.
Making the Grade
To keep their Medicaid, 'applicable individuals' (we'll get to who that is in a second) have to do one of the following each month:
- Work at least 80 hours.
- Earn at least the federal minimum wage multiplied by 80 (so, like working 80 hours at minimum wage).
- Do 80+ hours of community service.
- Be in a work program for 80+ hours.
- Mix and match work, service, or a work program to hit that 80-hour mark.
Before you panic, the bill says state Medicaid agencies have to check existing databases first to see if someone meets the requirement. They can't just start asking for paperwork right away (SEC. 1).
Who's 'Applicable'?
This doesn't apply to everyone. The bill lists a bunch of exemptions (SEC. 1). You're not an 'applicable individual' if you're:
- Under 18 or over 65.
- Declared physically or mentally unfit for employment.
- Pregnant.
- Taking care of a dependent child or an incapacitated person.
- Already meeting work requirements for another federal program.
- In drug or alcohol treatment.
- Going to school at least half-time.
Real-World Rollout
Imagine a single mom working part-time, around 60 hours a month, while also taking care of an elderly parent. Under this bill, she wouldn't meet the 80-hour requirement, even though she's clearly juggling a lot. Unless she qualifies for one of the listed exemptions, her healthcare coverage could be at risk. A retail worker, similarly, might have fluctuating hours that dip below 80 in some months, putting them in a precarious position. Even if they average 80 hours over the year, a single low month could jeopardize their benefits. The bill requires 3 months of compliance within a 12 month period. (SEC. 1).
The Big Picture
This bill essentially ties healthcare access to work or community engagement for a specific group of Medicaid recipients. While the goal might be to encourage work, it could create significant hurdles for people already struggling to make ends meet. It also puts the onus on states to manage this complex verification process, and gives them the power to drop people from Medicaid if they don't comply. This could lead to a lot of people losing healthcare coverage, especially those who face barriers to employment or have difficulty navigating the system.