Medicaid Work Requirements: Who Will the New State Policies Impact?

  • Jessica Greene
Concise Research Reports

Early in 2018, the Trump administration approved four states (AR, IN, KY, and NH) to implement Medicaid work requirements, a controversial policy requiring non-disabled adults to spend at least 20 hours a week working, volunteering, attending school or job training, or searching for employment in order to receive Medicaid. In October, Wisconsin's Medicaid work requirement was also approved, and there are 10 states with pending applications.  While the Centers for Medicare and Medicaid Services’ Administrator described work requirements as “a policy that makes Medicaid a path out of poverty,”1 the Obama administration rejected the policy because reducing health care access was viewed as inconsistent with the objectives of Medicaid.2In June, Arkansas was the first state to begin implementing Medicaid work requirements. The other four states are scheduled to begin implementation in 2019, though Kentucky may face a second legal challenge (the first halted implementation shortly before...



I would like to thank the Kaiser Family Foundation for sharing their survey data.

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Conflict of Interest

The author declares that she has no conflicts of interest.


  1. 1.
    Verma S. Making Medicaid a Pathway Out of Poverty. Washington Post. February 2, 2018. Available at: Accessed 4 September 2018.
  2. 2.
    Slavitt AM. Department of Health and Human Services Letter. September 30, 2016. Available at: Accessed 4 September 2018.
  3. 3.
    Owermohle S. Trump Admin Reapproves Kentucky's Medicaid Work Requirement Waivers. Politico Pusle. 11/21/2018. Accessed 16 December 2018.
  4. 4.
    Ku L, Brantley E. Myths about the Medicaid expansion and the “Able-Bodied.”. Health Affairs Blog. March 6, 2017. Available at: Accessed 4 September 2018.
  5. 5.
    Gangopadgyaya A, Kenney G. Who Could Be Affected by Kentucky’s Medicaid Work Requirements, and What Do We Know about Them? Washington, DC; 2/2018. Available at: Accessed September 4, 2018.
  6. 6.
    Hamel L, Firth J, Brodie M. Kaiser Family Foundation/New York Times/CBS News Non-Employed Poll. Washington, DC; 12/11/2014. Available at: Accessed 4 September 2018.

Copyright information

© Society of General Internal Medicine 2019

Authors and Affiliations

  1. 1.Marxe School of Public and International Affairs, Baruch CollegeCity University of New YorkNew YorkUSA

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