Eric Wunderlin struggled for many years to find stable employment due to his health issues. Managing depression and diabetes, he worked part-time, minimum-wage retail jobs in Dayton, Ohio, where he often had to choose between paying rent and buying food.
However, in 2018, his CareSource Medicaid health plan offered him assistance in finding a job. They connected him with a life coach who helped him secure full-time work with health benefits. Today, he works for a nonprofit social service agency and has achieved enough financial stability to plan a European vacation next year.
Republicans in Congress, as well as in states like Ohio, Iowa, and Montana, are advocating for work requirements for nondisabled adults on Medicaid. They believe that such mandates would encourage enrollees to find jobs, just like Wunderlin did. However, his success story is an exception rather than the norm.
Most Medicaid recipients are already employed or are unable to work due to caregiving responsibilities, school, disability, or illness. Implementing work requirements may lead to eligible individuals losing their Medicaid coverage without actually improving their economic prospects.
Efforts to help Medicaid recipients find employment have seen limited success as most enrollees are already working, albeit in jobs without health benefits. Ben Sommers, a health care economics professor at Harvard T.H. Chan School of Public Health, emphasizes that the idea of people freeloading on Medicaid is not supported by evidence.
While Arkansas and Georgia have implemented work requirements for some Medicaid enrollees, a study showed that the policies did not lead to increased employment rates. In Arkansas, over 18,000 people lost coverage due to the requirement before it was suspended by a federal judge in 2019.
States like California, Ohio, and Montana have experimented with various programs to help Medicaid enrollees find work. California offers nontraditional health benefits, including job assistance, to individuals experiencing homelessness or mental illness. The University of Pittsburgh Medical Center has successfully hired over 10,000 Medicaid enrollees through its training and support services.
Experts argue that work requirements alone are not enough to improve economic mobility. Investments in personalized life coaching, direct hiring by health plans, and job training programs are more effective in helping Medicaid recipients find stable employment.
While the debate over Medicaid work requirements continues, states and policymakers are exploring different strategies to support enrollees in achieving financial stability through meaningful employment opportunities.
