Some conservative states aren’t using Medicaid hardship exemption – for political reasons
Summary
New federal rules starting January 1 will require some Medicaid adults to work or participate in activities for 80 hours a month to keep their health coverage. Some conservative states are choosing not to use special hardship exemptions that protect people in places with high unemployment, likely due to political and administrative reasons.Key Facts
- Medicaid work requirements apply to adults who got coverage through the Affordable Care Act expansion.
- These adults must work, go to school, volunteer, or do other approved activities for 80 hours a month to keep Medicaid.
- The federal government allows states to exempt people in areas with high unemployment or other hardships.
- New York City used the exemption for the Bronx, benefiting about 200,000 people.
- Missouri and Iowa have counties that qualify for the exemption but are not using it.
- Experts say states may refuse exemptions due to political views or fear of extra paperwork.
- Conservative states often prefer to tie health insurance to work or community involvement.
- Past examples, like Arkansas, show work requirements have caused many people to lose Medicaid without increasing employment.
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