Bill Overview
Title: Jobs and Opportunities for Medicaid Act
Description: This bill establishes work requirements under Medicaid for able-bodied adults (i.e., those between the ages of 18 and 65 and who are not otherwise unable to work due to a medical condition, family situation, or other listed reason).
Sponsors: Rep. LaTurner, Jake [R-KS-2]
Target Audience
Population: Able-bodied adults receiving Medicaid
Estimated Size: 15000000
- Medicaid programs in many countries provide health coverage to low-income adults, including those who are unemployed or underemployed.
- The bill specifies 'able-bodied adults,' which excludes children, the elderly, and those with disabilities.
- The working-age population, typically defined as people between the ages of 18 and 65, are the primary target of this legislation.
- The global population between these ages is estimated to be in the billions, given the overall global population of over 8 billion.
Reasoning
- The estimated target population in the US is around 15 million. However, not all of them will be immediately impacted, as specific conditions and exemptions may apply to certain individuals.
- The Medicaid program serves low-income individuals, including working-age adults, but those meeting work requirements might not see huge shifts if they are already working or able to meet the requirements easily.
- Considering our budget limits, only a fraction of the target population can be addressed effectively in the first year. There might be a reallocation or additional support provided to make it feasible under the available budget.
- Wellbeing scores can fluctuate based on how individuals perceive the changes brought by the policy. Those seeing it as an opportunity may improve their wellbeing scores, whereas others might experience additional stress.
- We have considered a variety of individuals from different socioeconomic backgrounds, reflecting the diversity within the Medicaid population.
Simulated Interviews
part-time retail worker (Detroit, MI)
Age: 32 | Gender: female
Wellbeing Before Policy: 5
Duration of Impact: 5.0 years
Commonness: 7/20
Statement of Opinion:
- I am worried this policy might affect my ability to stay on Medicaid, especially with my unpredictable work schedule and childcare needs.
- I want to work more hours but it's hard to find a job that fits my situation.
Wellbeing Over Time (With vs Without Policy)
| Year | With Policy | Without Policy |
|---|---|---|
| Year 1 | 4 | 5 |
| Year 2 | 5 | 5 |
| Year 3 | 6 | 6 |
| Year 5 | 7 | 6 |
| Year 10 | 7 | 7 |
| Year 20 | 6 | 7 |
unemployed (Austin, TX)
Age: 45 | Gender: male
Wellbeing Before Policy: 6
Duration of Impact: 10.0 years
Commonness: 5/20
Statement of Opinion:
- This might be the push I need to find work, but I'm also concerned about losing my healthcare if I don't succeed.
- I've been trying to find a job but it's been tough due to my age and limited education.
Wellbeing Over Time (With vs Without Policy)
| Year | With Policy | Without Policy |
|---|---|---|
| Year 1 | 5 | 6 |
| Year 2 | 6 | 6 |
| Year 3 | 7 | 6 |
| Year 5 | 7 | 7 |
| Year 10 | 8 | 7 |
| Year 20 | 7 | 7 |
self-employed (San Francisco, CA)
Age: 29 | Gender: other
Wellbeing Before Policy: 7
Duration of Impact: 3.0 years
Commonness: 3/20
Statement of Opinion:
- My concern is the inconsistency of my income and whether I can meet these work requirements.
- The flexibility of freelancing means I sometimes earn very little in a month.
Wellbeing Over Time (With vs Without Policy)
| Year | With Policy | Without Policy |
|---|---|---|
| Year 1 | 6 | 7 |
| Year 2 | 7 | 7 |
| Year 3 | 7 | 7 |
| Year 5 | 8 | 7 |
| Year 10 | 8 | 8 |
| Year 20 | 6 | 7 |
part-time caregiver (Phoenix, AZ)
Age: 51 | Gender: female
Wellbeing Before Policy: 4
Duration of Impact: 5.0 years
Commonness: 6/20
Statement of Opinion:
- I'm really stressed about the potential work requirements since I'm already working as much as I can.
- Financially, I'm stretched thin, and my caregiving responsibilities make it hard to find other work.
Wellbeing Over Time (With vs Without Policy)
| Year | With Policy | Without Policy |
|---|---|---|
| Year 1 | 3 | 4 |
| Year 2 | 4 | 4 |
| Year 3 | 5 | 5 |
| Year 5 | 5 | 5 |
| Year 10 | 6 | 6 |
| Year 20 | 5 | 6 |
college student (Chicago, IL)
Age: 22 | Gender: male
Wellbeing Before Policy: 8
Duration of Impact: 3.0 years
Commonness: 4/20
Statement of Opinion:
- I'm worried how this might affect my studies if I'm forced to work more hours.
- Balancing school and work is already challenging without added stress from Medicaid requirements.
Wellbeing Over Time (With vs Without Policy)
| Year | With Policy | Without Policy |
|---|---|---|
| Year 1 | 7 | 8 |
| Year 2 | 8 | 8 |
| Year 3 | 8 | 8 |
| Year 5 | 9 | 8 |
| Year 10 | 9 | 9 |
| Year 20 | 8 | 8 |
seasonal agricultural worker (Rural Alabama)
Age: 38 | Gender: female
Wellbeing Before Policy: 5
Duration of Impact: 5.0 years
Commonness: 6/20
Statement of Opinion:
- There aren't many job opportunities here, especially in the off-season, so I'm worried.
- This could be an incentive to seek more stable work, but it's not easy to find.
Wellbeing Over Time (With vs Without Policy)
| Year | With Policy | Without Policy |
|---|---|---|
| Year 1 | 4 | 5 |
| Year 2 | 5 | 5 |
| Year 3 | 5 | 5 |
| Year 5 | 6 | 6 |
| Year 10 | 6 | 6 |
| Year 20 | 5 | 6 |
retired early (New York, NY)
Age: 60 | Gender: male
Wellbeing Before Policy: 6
Duration of Impact: 1.0 years
Commonness: 2/20
Statement of Opinion:
- Since I retired early for health reasons, I might still qualify, but it's a concern.
- Any additional pressure to find work while managing health issues is daunting.
Wellbeing Over Time (With vs Without Policy)
| Year | With Policy | Without Policy |
|---|---|---|
| Year 1 | 6 | 6 |
| Year 2 | 6 | 6 |
| Year 3 | 6 | 6 |
| Year 5 | 7 | 7 |
| Year 10 | 7 | 7 |
| Year 20 | 6 | 7 |
gap year before college (Atlanta, GA)
Age: 19 | Gender: female
Wellbeing Before Policy: 7
Duration of Impact: 0.0 years
Commonness: 3/20
Statement of Opinion:
- This might not affect me much since I'm planning to return to school.
- I hope the policy won't disrupt my preparation for college.
Wellbeing Over Time (With vs Without Policy)
| Year | With Policy | Without Policy |
|---|---|---|
| Year 1 | 7 | 7 |
| Year 2 | 8 | 8 |
| Year 3 | 8 | 8 |
| Year 5 | 9 | 9 |
| Year 10 | 9 | 9 |
| Year 20 | 8 | 8 |
small business owner (Los Angeles, CA)
Age: 36 | Gender: male
Wellbeing Before Policy: 8
Duration of Impact: 5.0 years
Commonness: 4/20
Statement of Opinion:
- I understand the policy's intent, but there should be more support for small business owners.
- Balancing my business and looking for supplementary work is stressful.
Wellbeing Over Time (With vs Without Policy)
| Year | With Policy | Without Policy |
|---|---|---|
| Year 1 | 7 | 8 |
| Year 2 | 8 | 8 |
| Year 3 | 8 | 9 |
| Year 5 | 9 | 9 |
| Year 10 | 9 | 9 |
| Year 20 | 8 | 9 |
unemployed (Miami, FL)
Age: 42 | Gender: female
Wellbeing Before Policy: 5
Duration of Impact: 10.0 years
Commonness: 5/20
Statement of Opinion:
- It will be challenging to find a job that allows me to care for my children.
- We can't afford to lose Medicaid; it's crucial for my kids.
Wellbeing Over Time (With vs Without Policy)
| Year | With Policy | Without Policy |
|---|---|---|
| Year 1 | 4 | 5 |
| Year 2 | 5 | 5 |
| Year 3 | 5 | 6 |
| Year 5 | 6 | 6 |
| Year 10 | 6 | 6 |
| Year 20 | 6 | 6 |
Cost Estimates
Year 1: $2000000000 (Low: $1500000000, High: $2500000000)
Year 2: $1800000000 (Low: $1400000000, High: $2200000000)
Year 3: $1600000000 (Low: $1200000000, High: $2000000000)
Year 5: $1500000000 (Low: $1000000000, High: $1800000000)
Year 10: $1200000000 (Low: $800000000, High: $1500000000)
Year 100: $300000000 (Low: $200000000, High: $400000000)
Key Considerations
- The administrative burden on states to implement and enforce work requirements could be substantial.
- Hospitals and clinics may face lower revenues from Medicaid patients who lose coverage due to non-compliance with work requirements.
- Potential legal challenges or public backlash against the policy may affect implementation timelines and effectiveness.
- Potential for increased churn in Medicaid rolls as beneficiaries cycle on and off the program due to compliance issues.