Ohio has asked the federal government for permission to require people in the state’s Medicaid expansion group to work at least 80 hours a month. But critics are concerned about the effect the requirements would have on the people removed from the Medicaid rolls and the state overall.
Under Ohio’s request, Medicaid recipients would have to work 80 hours a month unless they’re over 55, enrolled in school or job training, are in a recovery program or have a serious physical or mental illness. Medicaid director Maureen Corcoran said about 62,000 could lose coverage over the two year budget, but most of the 770,000 people in Medicaid expansion would not.
“Three quarters of them are already working, and others of those individuals would also meet one of the other statutory requirements," Corcoran said in testimony to a House committee last month.
Corcoran said there’s a higher percentage of substance abuse disorder and mental illness in Medicaid expansion. If there are more people who need to be assessed to determine if they meet work requirement exemptions, that could mean more costs or less in savings
Critics have said requirements is basically Medicaid cuts, and will mean more administrative costs for assessment and would increase the rate of uninsured people in Ohio.
"We know that for people with disabilities, work requirements actually make it harder to work," said Brandy Davis, who analyzes Medicaid policy for the Center for Community Solutions, which has opposed work requirements. "And we know for low wage workers, where most Medicaid enrollees work, are often marked by irregular hours, sometimes limited benefits, even exploitation. There could be little control over whether or not someone is employed."
David added: “Paperwork could oftentimes also be a barrier. There’s inadequate support for childcare. Sometimes even there's little flexibility when additional barriers arise relative to transportation and things like that.”
Ohio is among 41 states with Medicaid expansion, which was approved under Republican former Gov. John Kasich in 2013. Around a dozen states have tried to implement work requirements, but only two states have fully implemented them – Arkansas and Georgia. But Arkansas was ordered to end its work requirements in March 2019, so only Georgia has a work requirement now.
Ohio submitted a waiver for work requirements to the first Trump administration in 2019, and it was approved. But the COVID pandemic in 2020 derailed implementation of work requirements, and then in 2021 the Biden administration reversed the Trump administration’s approval.
