Commentary

NC Senators propose work reporting requirements for parents who receive Medicaid, even as judge strikes down requirements for other states

Yesterday, a federal judge struck down Medicaid work requirements implemented in Arkansas and proposed in Kentucky, emphasizing in the opinion the role of Medicaid in providing medical assistance to people with low income in our country.

Yet in rejection of the growing evidence of harm and legal opinions on this matter, leaders in the North Carolina General Assembly yesterday filed Senate Bill 387 which proposes implementing work reporting requirements on parents with very low incomes who currently receive health care through Medicaid. Requiring reporting on work is costly and complicated to comply with, likely leading to loss of coverage for parents. This will push up the number of people who are uninsured, particularly for households with very low incomes given current eligibility requirements, and fundamentally ignores the problems with our current labor market and what children need to thrive.

By applying work reporting requirements to people receiving health care through Medicaid, this bill jeopardizes the well-being of parents, the children themselves, and the broader community.

Those who will be impacted by the proposed Senate Bill 387 would include parents of school-age children, and toddlers to pre-schoolers. It undermines the best evidence of what works to support the well-being of children—access to health care and the financial security that can come from consistent care and healthy outcomes.

It will also lead to higher administrative costs and likely lead to coverage losses among those who are working, as has been demonstrated in other states like Arkansas. Work reporting requirements for people with low incomes will undermine our state’s progress towards ensuring affordable quality health care for more North Carolinians.

The realities of our labor market can’t be ignored any longer and can’t be fixed with a requirement for patients to report work hours to get the health care they need to lead healthy lives.

Rather than spend tax dollars to implement administrative barriers to access care, these funds would be much better spent in investing in job training programs for the counties that have not recovered from the Great Recession and in ensuring that children have all the supports they need from an early age to thrive.

  • North Carolinians with low incomes are struggling to make ends meet in low wage jobs. According to data from the Working Poor Families Project, 75 percent of North Carolinians with incomes below 200 percent of the federal poverty level (or incomes less than $51,500 for a family of four) are working. Moreover, 1 in 9 North Carolinians who work full-time year-round are uninsured.
  • North Carolinians with low incomes often have to work intermittently throughout the year or with irregular hours from week to week. Nationally, analysts have found that 1 in 4 Americans who work at least 1,000 hours in a year would be at risk of losing coverage because their work hours fluctuate enough in a given month that they would fall below reporting requirements established by some states to access health care. These reporting requirement thresholds are arbitrary and inflexible in the face of a job landscape where inconsistent work scheduling and temporary work are on the rise.
  • Too many North Carolinians are still struggling to find jobs in many communities that have not recovered from the Great Recession (and even in those that have). The most recent county data found that 45 counties still have fewer jobs than before the Great Recession. This lack of employment opportunity is particularly pronounced in rural areas but also affects urban neighborhoods that are disconnected from their broader regional labor market.

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