
Medicaid Expansion Not a “Welfare Trap” Despite Report's Claim, Other Research Finds
Findings from the Foundation for Government Accountability did not net out those who would be eligible for exemptions under CMS rules.
The language of the report sounded alarming: Medicaid expansion, a hallmark of the Affordable Care Act (ACA), had created “a new welfare trap” for the 12 million newly eligible adult enrollees. “With no work requirement in place,” the report stated, “nearly 7 million of these expansion enrollees have no reported income.”
The July 12
To do so, the report culls raw data from several states, and reports high shares of enrollees not collecting a paycheck: 55% in Arkansas, 52% in Kentucky, 48% in Pennsylvania, and 70% in Illinois.
But there’s just one problem: as other reviews of the same data have found, many of those enrolled in Medicaid expansion while not collecting a paycheck would qualify for an exemption under
An analysis by the
Katherine Hempstead, senior policy adviser for the Robert Wood Johnson Foundation, examined the FGA report and told The American Journal of Managed Care® in an email that the researchers had not netted out those who might be exempt from requirements. She cited Arkansas as an example. “The estimated share of enrollees who are both able to work and not working is far lower than that implied by the FGA report, which conveniently omits a lot of information related to the ability to work,” Hempstead said.
In May, the Kaiser Family Foundation
- No state-level studies found negative effects on employment or employee behavior.
- In Ohio, Medicaid expansion was found to be beneficial to those who were unemployed and looking for work.
- Several state-level studies predicted job growth following expansion, and Kentucky’s former governor had produced a report linking expansion with economic benefits.
Despite the FGA’s failure to account for exempted populations in its data, the report’s conclusions have appeared
Hempstead said even though Medicaid is health insurance, there is an effort to portray it as welfare. “Clearly, the politics of late are to try to recast it as the latter, by saying that ‘able-bodied’ people should not be using Medicaid, when no one says this about subsidies on the ACA exchange or Medicare,” she said.
In Kentucky, a federal judge focused on Medicaid’s health insurance mission in
After the judge blocked Kentucky’s
At press time, there was no response to an email to an FGA spokeswoman requesting comment.
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