Press Releases

Contact: First Focus
Phone: 202-657-0670

Work Requirements for Medicaid: Yet Another Threat to Children and Families


Washington, D.C. – First Focus responded to today’s letter issued by the Centers for Medicare and Medicaid Services (CMS) to State Medicaid Directors, allowing them to base Medicaid eligibility on work status or what is termed “community engagement.”

“This directive is yet another example of federal policymakers failing to understand the negative ramifications that their policies would have on children,” said Bruce Lesley, President of First Focus. “Let’s be very clear. Medicaid is a health care program for low-income children and parents, children and adults with disabilities, and senior citizens. It is essential and necessary health care for vulnerable people who need it and cannot otherwise afford it. It is not a cash payment. It gives people the ability to address the health care needs they have in order to work, but to also care for their children.”

While ten (10) states have applied for waivers to their Medicaid programs that would allow them to impose work requirements, today’s letter opens the door nationwide for states to require work as a condition of eligibility for Medicaid. It is a dramatic and disturbing departure from the core mission of Medicaid and defies extensive research and data showing that the vast majority of people with Medicaid coverage who can work, are working. Moreover, Medicaid waivers are intended as a means for states to expand coverage for Medicaid, not limit access. While the guidelines state there are protections for certain populations, how those protections will be implemented in various states is a significant question.

“How such a directive might harm children with disabilities, despite any purported protections, is very alarming,” said Morna Murray, Senior Vice President for Health and Disabilities for First Focus. “There are millions of children with disabilities who require full-time parental care. Where is the sense in requiring those parents to abandon the daily care of their children in order to ensure they have critical health care coverage?”

First Focus will be extensively analyzing the many dangerous ramifications of the guidelines for children and families, including the impact upon: youth who age out of the foster care system; pregnant women; parents without access to child care; children and parents with disabilities; victims of the opioid crisis, and more.