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Monday Morning Medicaid Must Reads: Jan 7th, 2019

Helping you consider differing viewpoints. Before it’s illegal.

In this issue…

Article 1:   Healthy and Working: Benefits of Work Requirements for Medicaid Recipients, Buckeye Institute, December 2018

Clay’s summary:   Beware the red pill.
Key Excerpts from the Article:
Extending Medicaid benefits to individuals who are able to work may reduce their lifetime earnings over the  long-term and adversely affect their consumption patterns in the short-term. Although households may benefit in  the short-term from Medicaid coverage through little- or no-cost health care, the ACA’s Medicaid expansion does  not promote individual long-term earnings growth or wealth accumulation. Workers have less incentive to invest in  their human capital than if they were required to work in order to receive benefits.
 
To address this concern, states that have participated in the ACA’s Medicaid expansion are now considering—or  have already begun to impose—work requirements for some new Medicaid enrollees. Work and “community  engagement” requirements, such as education and job training, tend to keep benefits recipients participating in the  work force, helping them to gain valuable work experience and generate higher earnings and income over the  long-term.
Using publicly available economic data, this report reveals the potential impact of imposing work requirements on  healthy, single individuals with no children. We study how eligibility work requirements may affect the lifetime  earnings of some Medicaid enrollees and find that Medicaid work requirements could:
 
* • Increase lifetime earnings by $212,694 for women and $323,539 for men—even assuming that the  individual remains on Medicaid for their entire working life; and
* • Raise the hours worked per week by 22 hours for women (from 12 hours to 34 hours per week), and by  25 hours for men (from 13 hours to 38 hours per week), bringing Medicaid recipients well above the typical 20  hours per week requirement.
 
We also find that the financial prospects look even brighter for individuals who transition off of Medicaid; they  may earn close to $1 million more over the course of their working years.
 
Requiring labor force participation for benefits eligibility creates an incentive for individuals to increase human  capital investment through the labor market. We show that there is a significant potential economic benefit for  those able-bodied adults who would change their work effort in response to a work requirement for Medicaid  eligibility.
Read full article in packet or at links provided

Article 2:   State Trends and Analysis, Pew Trusts, November 2018

Clay’s summary:   Turns out you do have to choose between healthcare and education. Until we find where the unicorns are hiding the magic wands, that is.
Key Excerpts from the Article:
Medicaid’s claim on each revenue dollar affects the share of state resources available for other priorities, such as education, transportation, and public safety. Because Medicaid is an entitlement program, states must provide certain federally required benefits for any eligible enrollee, even during times of sluggish revenue growth. So policymakers have less control over growth in states’ Medicaid costs than they do with many other programs.
Read full article in packet or at links provided

Article 3:   Estimated Impacts of the Proposed Public Charge Rule on Immigrants and Medicaid, KFF, October 2018

Clay’s summary:   The potential safety net costs for newly arriving Americans may be getting more attention if the rule is passed.
Key Excerpts from the Article:
On October 10, 2018, the Trump administration released a proposed rule to change “public charge” policies that govern how the use of public benefits may affect individuals’ ability to obtain legal permanent resident (LPR) status. The proposed rule would expand the programs that the federal government would consider in public charge determinations to include previously excluded health, nutrition, and housing programs, including Medicaid. It also identifies characteristics DHS could consider as negative factors that would increase the likelihood of someone becoming a public charge, including having income below 125% of the federal poverty level (FPL) ($25,975 for a family of three as of 2018). This analysis provides new estimates of the rule’s potential impacts. Using 2014 Survey of Income and Program Participation data, it examines the (1) share of noncitizens who originally entered the U.S. without LPR status who have characteristics that DHS could potentially weigh negatively in a public charge determination and (2) number of individuals who would disenroll from Medicaid under different scenarios:
Nearly all (94%) noncitizens who originally entered the U.S. without LPR status have at least one characteristic that DHS could potentially weigh negatively in a public charge determination. Over four in ten (42%) have characteristics that DHS could consider a heavily weighted negative factor and over one-third (34%) have income below the new 125% FPL threshold.
Read full article in packet or at links provided