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

By Sam Whitehead Phil Galewitz and Katheryn Houghton KFF Wellness News For various years Eric Wunderlin s physical condition 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 stated he sometimes had to choose between paying rent and buying food But in his CareSource Medicaid vitality plan offered him help getting a job It connected him to a life coach who helped him find full-time work with robustness benefits Now he works for a nonprofit social facility agency a job he revealed 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 mentioned 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 ruling body healthcare coverage can help people find employment and ultimately reduce their need for constituents 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 majority 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 the majority of the rest acting as care providers going to school or unable to hold a job due to disability or illness according to KFF a healthcare information nonprofit that includes KFF Strength 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 reported Ben Sommers a professor of robustness care economics at the Harvard T H Chan School of Society Wellness The greater part Medicaid enrollees already work just not in jobs with medical benefits he commented The ongoing argument that various folks make is that there are a lot of people freeloading in Medicaid he announced That s just not supported by the evidence Using physical condition 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 numerous were struck down by federal judges who stated they were illegal under federal law Initiative experts and state executives say more attention should be paid to investments that have helped people find better jobs from personalized life coaching to in specific cases soundness plans directly hiring enrollees They argue work requirements alone are not enough The move to economic mobility requires a ladder not a stick mentioned 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 development 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 particular Medicaid enrollees work volunteer go to school or enroll in job training But a evaluation Sommers co-authored revealed no evidence work requirements in Arkansas operation led to more people working in part because the bulk of those who could work already were In Arkansas more than people lost coverage under the state s requirement before the program was suspended by a federal judge in after less than a year Those who lost their Medicaid robustness care stated being unaware or confused about how to account work hours Since Arkansas has been giving Medicaid medical plans financial incentives to help enrollees train for jobs but so far sparse have taken advantage A few plans including Arkansas Blue Cross and Blue Shield s offer members to to complete a career readiness certificate In several Arkansas wellbeing plans offered enrollees educational videos about topics including taxes and cryptocurrency Medical 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 declared Karin VanZant a vice president at Clearlink Partners a wellness care consulting company Rather than offering incentives for providing job training a few states such as California and Ohio require the insurance companies that run Medicaid to help enrollees find work In Montana where chosen lawmakers are pushing to implement work requirements a promising optional scheme nearly collapsed after state lawmakers required it be outsourced to private contractors Within the venture s first three years the state paired Medicaid enrollees with existing federally funded job training programs The greater part had higher wages a year after starting training the state uncovered But enrollment has plummeted to just people according to the latest input provided by the state s labor department Sarah Swanson who heads the department mentioned several of the nonprofit contractors that ran the campaign shuttered There was no real part in this for us to deliver direct services to the folks that walked through our door she revealed 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 input to track the effectiveness of existing job programs offered by Medicaid plans Stephanie O Grady a spokesperson for the Ohio Department of Medicaid mentioned the state does not track outcomes because the vitality plans are not employment agencies Authorities with CareSource which operates Medicaid plans in multiple states say it has about Medicaid and ACA marketplace enrollees in its JobConnect scheme about in Ohio in Georgia and in Indiana The effort 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 announced Jesse Reed CareSource s director of life services in Ohio Since about people have located jobs through the scheme 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 disclosed 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 danger of avoidable urgency room care As of September it had served nearly enrollees but the state doesn t have information on how a large number of became employed The University of Pittsburgh Health 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 advocacy services Among other jobs they took positions as warehouse workers customer utility representatives and healthcare assistants The vast majority left low-paying jobs for full-time positions with wellness benefits explained Dan LaVallee a senior director of UPMC Wellbeing Plan s Center for Social Impact Our Pathways to Work campaign is a model for the nation he explained Josh Archambault a senior fellow with the conservative Cicero Institute declared Medicaid should focus on improving the financial vitality 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 disclosed KFF Wellness News senior correspondent Angela Hart contributed to this record KFF Robustness News Distributed by Tribune Content Agency LLC