![]() ![]() There would be exemptions for those who are physically or mentally unfit for employment (as determined by a physician or other medical professional), pregnant, the parent or caretaker of a dependent child or incapacitated person, complying with a work requirement under a different federal program, participating in drug or alcohol treatment or rehabilitation program, or enrolled in school at least half time. Under the Medicaid work requirement plan, certain adult enrollees ages 19-55 would need to work or participate in other qualifying activities (like community service or job training) for at least 80 hours per month. What is the work requirement policy in the debt ceiling bill? ![]() ![]() A small number of states with the largest share of enrollees under the Affordable Care Act (ACA) Medicaid expansion would account for almost half of the increased state spending or coverage losses. If states chose to keep all 1.7 million people enrolled, $10.3 billion of Medicaid spending would shift from the federal to state governments in 2024. It is unclear if any states would choose to do that, though CBO estimated over half of enrollees would continue to be covered at the states’ expense. States could continue to provide Medicaid to those enrollees but would not receive federal matching funds for doing so. We estimate that if the proposal were fully implemented in 2024 and the rate of Medicaid eligibility loss was as the Congressional Budget Office (CBO) estimated, then 1.7 million enrollees would not meet work or reporting requirements and potentially face disenrollment in that year. Data show that 91% of non-elderly Medicaid enrollees who are not on Supplemental Security Income or Medicare are working or face barriers to work. On April 26, 2023, the House of Representatives passed a Republican debt ceiling bill (HR 2811, the Limit, Save, Grow Act of 2023) that includes a requirement for states to implement work requirements for certain Medicaid enrollees. Note: This analysis was updated on clarify an error about verification for exemptions. ![]()
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