Medicaid Work Requirements For Parents Will Harm Children


This week, First Focus submitted comments to Health and Human Services Secretary Azar about the Medicaid waivers from Mississippi and Kentucky. Both states proposed adding work requirements to their adult Medicaid program, while Kentucky included premiums and a lockout period of up to six months. First Focus urged the secretary to reject both waiver proposals.

In Mississippi the waiver request is particularly punishing since Mississippi did not expand Medicaid to uninsured adults as allowed under the Affordable Care Act. The adults who receive Medicaid coverage in Mississippi live in extreme poverty and get by on $467/month for a family of three, under 27% of the Federal Poverty Level. The states’ own budget neutrality estimates project that around 5,000 parents will lose Medicaid coverage in the first year if this waiver is approved. In fact, the waiver is designed for that to happen; if a parent meets the 20 hour/week work requirement at a minimum wage job, they will make too much money, $580/month, disqualifying them for Medicaid. Literally, they are damned if they do and damned if they don’t.

In Kentucky the premiums for Medicaid and lockout periods associated with work requirement reporting will result in otherwise eligible adults and parents losing coverage. As in other states, we know that Medicaid losses for parents put their children’s coverage at risk. It’s well-proven that when parents lose their coverage, children’s coverage drops, even when those kids remain eligible for Medicaid or CHIP.

First Focus opposes work requirements for programs like Medicaid, SNAP, housing supports, and TANF. Actions to limit household access to health care and effective anti-poverty programs will result in a future generation of children whose physical, mental health, nutritional, and educational outcomes are weakened. Instead, we should build on what works and promote policies that ensure that every child has access to health care, proper nutrition, stable housing, and enough resources to support their healthy development.