NC Budget and Tax Center, public health

Analysis: 5 reasons a Medicaid work requirement would hurt North Carolina’s struggling families

Lawmakers in Congress and in North Carolina’s General Assembly are considering “work requirements” in Medicaid as part of an overall health care reform package. However, evidence shows that denying medical care to sick, poor people because they lack a job is not a good idea.

Here in North Carolina too many families across the state are one bad accident, lay-off, or catastrophe away from the brink. Regardless of politics, we all share in the responsibility to ensure that when our most vulnerable do hit hard times, they do not go without the basics – housing, food, and medical care.

The NC Budget & Tax Center has released a Brief that lists 5 reasons why a Medicaid work requirement is not a good policy idea in North Carolina. Here’s a quick summary (bonus: the conclusion at the bottom points out what we really need in NC):

 1) Medicaid beneficiaries want to work but can’t find jobs for reasons that work requirements don’t solve.

In North Carolina, nearly 8 in 10 Medicaid adults live in a family with at least one worker. Most people on Medicaid who can work do so, and for people who face major obstacles to employment, work requirements won’t help to overcome them. Such barriers to work include having an illness or disability that prevents them from working (35 percent), lacking child care assistance or are taking care of family (28 percent), participating in school (18 percent).

Furthermore, in 88 of the state’s 100 counties, there are more unemployed workers than there are job openings. This is a major challenge that policymakers must address to enable more jobless adults to access employment opportunities. Medicaid work requirements do not address the job gap.

2) Low wages keep millions of working people across North Carolina in poverty.

Across all 100 counties in NC, there are 2.2 million North Carolinians who have a job but are still earning poverty-level incomes, which is $24,600 for a family of 4. There are 95 counties in which the working poor make up more than 20 percent of the labor force. In 17 of the state’s 100 counties, the working poor population is between 30 and 40 percent. In other words, having a job is good but not enough to get by for many people across the state.

3) Medicaid makes it easier for people to work and search for work.

According to a statewide Medicaid assessment, a majority of enrollees (52 percent) report that Medicaid has made it easier to secure and maintain employment. Among unemployed enrollees looking for work, 75 percent report that Medicaid makes it easier to look for work.

4) A Medicaid work requirement redirects resources away from the goal of reducing poverty.

Spending taxpayer money to cover increasing administrative costs rather than using it to serve the public is not smart public policy. A work requirement for Medicaid beneficiaries would add to health plan administrative costs and shift money away from providing care, according to health insurers that administer benefits for millions of poor Americans. Jeff Myers, president and CEO of Medicaid Health Plans of America, has said work requirements are an administrative burden: “plans would rather spend their time and resources actually caring for their members.

 5) Dedicating resources to work training programs that help people access job opportunities is more effective in the long-term.

To help North Carolinians who are struggling find work and to secure better jobs, investments targeted to skills training programs that result in an industry-recognized credential and providing a strong career pathway program at every community college will increase skills and employment outcomes.

Research shows that public investments in these areas help low-income adults and youth find jobs, improve their earnings and contribute to their communities. For example, one study found that individuals receiving services are more likely to be employed (by about 10 percentage points) than those who have not received services.

 Conclusion

It is clear that instead of cutting funding and making it more difficult for vulnerable parents and children to access health programs in times of need, what we really need in NC is to change how we end poverty  – by providing adequate funding to help North Carolinians create and find work, get access to education and job training, child care, or mental health services to lift them out of poverty.

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