States push Medicaid work rules, but few programs help enrollees find jobs

By Sam Whitehead Phil Galewitz and Katheryn Houghton KFF Robustness News For numerous years Eric Wunderlin s healthcare issues made it hard to find stable employment Struggling to manage depression and diabetes Wunderlin worked part-time minimum-wage retail jobs around Dayton Ohio making so little he reported he sometimes had to choose between paying rent and buying food But in his CareSource Medicaid medical plan offered him help getting a job It connected him to a life coach who helped him find full-time work with medical benefits Now he works for a nonprofit social provision agency a job he disclosed has given him enough financial stability to plan a European vacation next year I feel like a real person and I can go do things explained Wunderlin I feel like I pulled myself out of that slump Related Articles Battenfeld Trump declaring war on elitist Harvard pocketbook Supreme Court blocks for now deportations of Venezuelans held in northern Texas under an th century wartime law EEOC instructs staff to sideline all new transgender discrimination cases employees say Tropical drinks by the pool Not so fast says senator who visited Abrego Garcia in El Salvador Judge blocks Trump administration from passport changes affecting transgender Americans Republicans in Congress and several states including Ohio Iowa and Montana are pushing to implement work requirements for nondisabled adults arguing a mandate would encourage enrollees to find jobs And for Republicans pushing to require Medicaid enrollees to work Wunderlin s story could be held up as evidence that governing body physical condition coverage can help people find employment and ultimately reduce their need for populace assistance Yet his experience is rare Medicaid typically does not offer such help and when states do try to help such efforts are limited And opponents point out that most of Medicaid recipients already have jobs and say such a mandate would only kick eligible people off Medicaid rather than improve their economic prospects Nearly two-thirds of Medicaid enrollees work with most of of the rest acting as supporters going to school or unable to hold a job due to disability or illness according to KFF a robustness information nonprofit that includes KFF Healthcare News Existing efforts to help Medicaid recipients get a job have seen limited success because there s not a lot of room to move the needle announced Ben Sommers a professor of wellness care economics at the Harvard T H Chan School of Society Healthcare The bulk Medicaid enrollees already work just not in jobs with medical benefits he announced The ongoing argument that specific folks make is that there are a lot of people freeloading in Medicaid he commented That s just not supported by the evidence Using wellbeing programs to encourage work The GOP-controlled Congress could allow or require states to implement a Medicaid work requirement as part of revamping and downsizing Medicaid The first Trump administration encouraged those work mandates but multiple were struck down by federal judges who announced they were illegal under federal law Program experts and state administrators say more attention should be paid to investments that have helped people find better jobs from personalized life coaching to in various cases robustness plans directly hiring enrollees They argue work requirements alone are not enough The move to economic mobility requires a ladder not a stick revealed Farah Khan a fellow with the Brookings Institution a nonpartisan think tank While Medicaid work requirements have been debated for decades the issue has become more heated as states and Washington D C have expanded Medicaid eligibility under the Affordable Care Act to the vast majority of low-income adults More than million adults have gained coverage as a end but Republicans are now considering eliminating the billions in extra federal funding that helped states extend eligibility beyond groups including multiple children pregnant women and disabled people Only Georgia and Arkansas have implemented mandates that specific Medicaid enrollees work volunteer go to school or enroll in job training But a research Sommers co-authored exhibited no evidence work requirements in Arkansas campaign led to more people working in part because greater part of those who could work already were In Arkansas more than people lost coverage under the state s requirement before the initiative was suspended by a federal judge in after less than a year Those who lost their Medicaid vitality care published being unaware or confused about how to statement work hours Since Arkansas has been giving Medicaid healthcare plans financial incentives to help enrollees train for jobs but so far sparse have taken advantage Several plans including Arkansas Blue Cross and Blue Shield s offer members to to complete a career readiness certificate In specific Arkansas wellness plans offered enrollees educational videos about topics including taxes and cryptocurrency Strength plans don t have an incentive to help someone find a better-paying job because that could mean losing a customer if they then make too much to qualify for Medicaid stated Karin VanZant a vice president at Clearlink Partners a vitality care consulting company Rather than offering incentives for providing job training particular states such as California and Ohio require the insurance companies that run Medicaid to help enrollees find work In Montana where specific lawmakers are pushing to implement work requirements a promising optional venture nearly collapsed after state lawmakers required it be outsourced to private contractors Within the undertaking s first three years the state paired Medicaid enrollees with existing federally funded job training programs Most of had higher wages a year after starting training the state identified But enrollment has plummeted to just people according to the latest figures provided by the state s labor department Sarah Swanson who heads the department mentioned several of the nonprofit contractors that ran the effort shuttered There was no real part in this for us to deliver direct services to the folks that walked through our door she noted The state hopes to revive job training by allowing the department to work alongside contractors to reach more people The hunt for results State administrators say they don t have much figures to track the effectiveness of existing job programs offered by Medicaid plans Stephanie O Grady a spokesperson for the Ohio Department of Medicaid stated the state does not track outcomes because the soundness plans are not employment agencies Bureaucrats with CareSource which operates Medicaid plans in multiple states say it has about Medicaid and ACA marketplace enrollees in its JobConnect activity about in Ohio in Georgia and in Indiana The undertaking connects job seekers with a life coach who counsels them on skills such as showing up on time dressing the part for interviews and selling yourself during the interview reported Jesse Reed CareSource s director of life services in Ohio Since about people have detected jobs through the project according to Josh Boynton a senior vice president at CareSource The vitality plan itself has hired Medicaid enrollees into customer facility pharmacy and other positions nearly all full-time with benefits he stated In California started offering nontraditional medical benefits through Medicaid including help finding jobs for enrollees experiencing homelessness or serious mental illness or who are otherwise at liability of avoidable crisis room care As of September it had served nearly enrollees but the state doesn t have statistics on how several became employed The University of Pittsburgh Clinical Center which is among the largest private employers in Pennsylvania running both a sprawling hospital system and a Medicaid plan has hired over of its Medicaid enrollees since through its training and sponsorship services Among other jobs they took positions as warehouse workers customer amenity representatives and medicinal assistants The vast majority left low-paying jobs for full-time positions with healthcare benefits declared Dan LaVallee a senior director of UPMC Strength Plan s Center for Social Impact Our Pathways to Work scheme is a model for the nation he revealed Josh Archambault a senior fellow with the conservative Cicero Institute commented Medicaid should focus on improving the financial strength of those enrolled While the first Trump administration approved Medicaid work requirements in states the Biden administration or federal judges blocked all except Georgia s I don t think states have been given ample chance to experiment and try to figure out what works Archambault declared KFF Robustness News senior correspondent Angela Hart contributed to this account KFF Fitness News Distributed by Tribune Content Agency LLC