New Report: 86,000 to 136,000 in Kentucky Will Lose Medicaid in the First Year Work Requirements Are Implemented

Medicaid eligibility paperwork

More than six months have elapsed since a federal court struck down the federal government’s initial approval of Kentucky’s Medicaid Section 1115 demonstration project that would require many of the state’s Medicaid recipients to work, volunteer or train for a job as a condition of coverage. Since then, the federal government has reapproved Kentucky’s project and this has again been challenged in court.  All along, researchers at the George Washington University Milken Institute School of Public Health (Milken Institute SPH) have been tracking the accumulating evidence about the effects of Medicaid work requirements. A new report published on GWHealthPolicyMatters presents some of their newest findings.

“Of the new evidence that has accumulated about the effects of work requirements in Medicaid, the most germane data come from a similar, but not identical, project initiated in Arkansas in June 2018, also approved by the Centers for Medicare and Medicaid Services under a Section 1115 demonstration project,” says Leighton Ku, PhD, MPH, director of the Milken Institute SPH’s Center for Health Policy Research. “As of December 2018, data from the Arkansas Department of Human Services indicated that in the first six months of implementation of the work experiment in that state, almost 17,000 adults had lost Medicaid coverage. These estimates were widely reported.”

Ku and Erin Brantley, a senior research associate at the Milken Institute SPH, developed a model to estimate Medicaid coverage losses associated with the work requirements. Using the model with the latest available data for Arkansas, they estimate that Medicaid coverage losses there will exceed 26 percent. 

In new research published in GWHealthPolicyMatters (below), Ku and Brantley used the model to estimate the potential effects of Kentucky’s Medicaid work requirements. “We now estimate that, as approved, the Kentucky’s work requirement policy could lead to the loss of Medicaid coverage by 86,000 to 136,000 adults in the first year alone or between 26 percent and 41 percent of those required to comply, losses higher than those claimed by the state or the federal agency,” they say in their new report, accessible below. “Kentucky’s 2014 Medicaid expansion successfully increased insurance coverage and access to care; the new policy threatens to reverse that progress.”

“Updated Estimates of the Effects of Medicaid Work Requirements in Kentucky,” by Ku and Brantley, is available below.