ASU researchers call Arizona Medicaid work requirements ‘unnecessary’

The constitutionality of the statute is being debated and researchers say data does not support its intention

Arizona’s Medicaid agency, Arizona Health Care Cost Containment System, suspended a state statute that would place work requirements on Medicaid in October, and ASU health researchers said the requirements are unnecessary.  

Medicaid recipients would be required to report at least 80 hours of work or education monthly in order to keep their subsided insurance. 

Heidi Capriotti, AHCCCS’s public information officer, said the agency decided to delay the statute because of the legal battles in other states that call the rule’s constitutionality into question. Capriotti said they are still committed to implementing the statute, but the efforts are paused “until further notice."

“We want to avoid any disruptions to Arizona’s vulnerable members who are on AHCCCS who would be required to comply with these requirements,” Capriotti said. 

Arizona’s statute, which was approved by the federal government in January, followed several other states’ new requirements until legal battles arose questioning the constitutionality of the requirements.

A judge blocked similar requirements in Kentucky and Arkansas, ruling that the requirements undermine Medicaid’s mission. Several other states are also in the process of implementing similar statutes, but faculty researcher at the College of Health Solutions Matthew Speer said a federal ruling put a pause on these conversations.

Speer said most Medicaid recipients are already in compliance with these requirements, and the rule would primarily affect people who have difficulty working.

“The majority of able-bodied adults that are Medicaid recipients are actually already working,” Speer said. “We have data to suggest that it’s at least 60%.”

Speer said this means the work and educational requirements would affect a small portion of the program’s recipients, and it puts those who cannot work for unique reasons in danger of losing care. 

Exceptions to this requirement would be made for Native American people, caregivers and people with disabilities, among other groups, Capriotti said.

Capriotti also mentioned temporary exceptions for those who have experienced “adverse events,” such as a car accident or family death. Exemptions would be on a month by month basis. Capriotti said full-time students or students with a combination of work and school would meet the requirements. She said it is possible that some part-time students could lose coverage.

Asha Ramakumar, a senior studying business and global politics and researching health related issues said even with exceptions the statute could cause Medicaid recipients to lose coverage unfairly. 

Ramakumar said women often take on unofficial responsibilities that support their spouse or a whole family, and they could be at risk of losing coverage because official work is not an option for them. 

Ramakumar also said the statute puts unfair and inaccurate assumptions on those who receive Medicaid. 

“The assumption that they’re making is that poor people are lazy, poor people don’t want to work, and they just want to stay on Medicaid and that they have to mandate them to work,” Ramakumar said.

Because of the legal battles and suspension of the rule, Capriotti said AHCCCS has not laid out a concrete plan for exactly how these requirements would be reported and verified. She said that a vendor would be contracted to create an online portal for reporting.  

Speer said that in Arkansas, where their statute already took effect, more than 18,000 people lost coverage, 1,000 reapplied and less than 1% reported incentivized employment.  

This loss of coverage of qualified Medicaid recipients can bring on major expenses when an uninsured patient needs care in the future, Speer said.

Ramakumar said the research does not support a need for this requirement or its effectiveness, and Speer said that without proper scaffolding, the requirement would lead to extreme loss of coverage and larger expenses for the state.

“Medicaid is supposed to expand coverage, not do what they’re doing here,” Ramakumar said.


Reach the reporter at gmlieber@asu.edu or follow @G_Mira_ on Twitter. 

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