Behavioral And Other Chronic Conditions Among Adult Medicaid Enrollees: Implications For Work Requirements

Health Aff (Millwood). 2019 Apr;38(4):660-667. doi: 10.1377/hlthaff.2018.05059.

Abstract

Work requirements condition Medicaid eligibility on completing a specified number of hours of employment, work search, job training, or community service. Little is known about how behavioral health and other chronic health conditions intersect with employment status among Medicaid enrollees who may be subject to work requirements. Using data from the National Survey on Drug Use and Health for the period 2014-16, we found that people with behavioral health and other chronic health conditions were more likely to be enrolled in Medicaid and subject to work requirements than those without any identified health conditions. Furthermore, among Medicaid enrollees, those with behavioral and other health conditions were also less likely to have worked twenty hours or more in the past week (and thus be more unlikely to meet work requirements). Our findings suggest that people who may be subject to the requirements have an elevated prevalence of behavioral and other chronic health conditions. If work requirements are to be a continued piece of Medicaid policy, policy changes must also be adopted to ensure that Medicaid covers a full continuum of evidence-based behavioral health services and that Medicaid enrollees with work-limiting conditions are given reasonable accommodations and exemptions.

Publication types

  • Research Support, N.I.H., Extramural
  • Review

MeSH terms

  • Adult
  • Chronic Disease
  • Employment / economics
  • Employment / statistics & numerical data*
  • Female
  • Health Policy
  • Humans
  • Insurance Coverage / statistics & numerical data*
  • Male
  • Medicaid / economics*
  • Medicaid / statistics & numerical data
  • Mental Disorders / diagnosis
  • Mental Disorders / economics
  • Mental Disorders / therapy*
  • Mental Health Services / organization & administration*
  • Patient Protection and Affordable Care Act
  • Policy Making
  • Risk Assessment
  • Surveys and Questionnaires
  • United States
  • Workplace / psychology*
  • Workplace / statistics & numerical data