All three states are expected to see a decline of more than 20 percent in their Medicaid rolls. (The District of Columbia will be similarly affected; see chart.)
By far the biggest decreases will come from the biannual eligibility checks and the “community engagement” requirement. Medicaid enrollees will need to prove that they have spent at least 80 hours a month working, doing community service or enrolled in school training. (They can also meet this requirement if they have earned the equivalent of 80 hours of work at minimum wages.)
States will also lose revenue due to new limitations on taxes they collect from those who provide Medicaid services to help them meet the state share of Medicaid payments.
Some new rules, including the community service requirement, are aimed specifically at states that expanded Medicaid programs under the Affordable Care Act. The ten states that did not will see the smallest change in enrollment, say the RAND researchers.
Based on outcomes in states that have enacted Medicaid work requirements, they estimate that 10 percent of Americans who are eligible to receive this federal insurance will lose coverage due to “administrative and informational barriers.” The number thus affected could reach 5.2 million by 2034.
