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Medicaid Work Requirement Red Tape Threatens Coverage for Family Caregivers

More and more states are moving to restrict Medicaid coverage by requiring low-income adults to report that they are working. In fact, the list of states that are in the process of designing or implementing these so-called “community engagement” or work requirement policies has grown to seventeen. Unfortunately, these harmful policies are especially dangerous for family caregivers because they create so much red tape and ignore the stressful and often complex situations these individuals face.

Medicaid is an important source of health insurance coverage for many of the 40 million family caregivers in the United States who do not have access to other affordable coverage options. Yet states are taking away that coverage by requiring low-income adults who are eligible for Medicaid to work a certain number of hours per month or qualify for an exemption.

Low-income family caregivers may be unable to work the requisite hours at a paid job because of their caregiving responsibilities, and only 5 states explicitly count caregiving hours towards meeting the work requirement. Although every state that is implementing or planning to impose work requirements provides some exemptions for family caregivers, the majority of states limit the caregiver exemption to caring for a dependent, a relative/family member, or a household member. Requiring family caregivers to report caregiving hours or prove they are exempt to maintain their Medicaid coverage puts the greatest burden on those who already face the most stressful situations of caring for a loved one with significant and complex needs.

What makes these policies even more harmful is that the onerous and sometimes impossible reporting requirements alone are blocking coverage for individuals who are working the requisite number of hours or who qualify for a caregiver or other exemption. As we see, Arkansas, the first state to implement the policy, is creating red tape by requiring individuals to gather documentation and report compliance. Yet, the state is not communicating the requirements clearly so that people understand them, nor is it providing necessary supports, such as internet access to help people report compliance, or transportation to find or get to work.

Because of these bad policies, caregivers in Arkansas have already been denied access to the coverage they need to maintain their own health, harming both their own well-being and the well-being of the older adults they care for. Taking away Medicaid coverage from family caregivers will increase the health disparities those who are low-income, older, women, and people of color already face. It puts more older adults at risk of being institutionalized because their family or friends can no longer care for them at home and in their communities.

And many more family caregivers will be in the same dangerous situation if these policies continue to move forward. That’s why it’s critical to fight back! Tell your state policy makers and the Trump Administration the stories of the family caregivers and older adults who are being harmed, whether your state is considering such a proposal or already in the implementation stage.

Justice in Aging recently conducted a state-by-state survey of how Medicaid work requirements apply to family caregivers and wrote a report explaining how they threaten the health and well-being of family caregivers and the older adults they care for.

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