Able bodied adult on Medicaid? Be prepared to work

With almost one in five Americans enrolled into the Medicaid program, the recent decision by the federal government to allow states to impose work type requirements will be a major change to this entitlement. Any able bodied adult who is receiving their health care from Medicaid may now be forced to work, volunteer, attend job training, or participate in some other productive activity if they want to stay enrolled.

To put this into perspective, there are over 70 million Americans who receive their health and/or dental care from Medicaid. While of course many of them will be senior citizens, children, sick, disabled, addicted to drugs, or facing some other challenge, the recent announcement from the Centers for Medicare & Medicaid Services is bound to impact millions of those beneficiaries.

The Kaiser Family Foundation reports that as of 2014, about 33% of Medicaid enrolless were adults. Digging into the data further, the Kaiser Family Foundation seems to indicate that 60% of adults who are enrolled in Medicaid already work. But that is a rough estimate and is hard to nail down a precise figure. However, if the data is accurate, then that means up to 40% of able bodied adults will need to be in training, school, etc. if they are not already so.

Now it would be very difficult (if not impossible) to determine how many are able bodied from that report and that are not currently “contributing” to society. But we would guess the federal government work requirements would impact millions of people. So this is a major change to one of the most “popular” government entitlement programs.

What will Medicaid require?

Keep in mind that the program is run in partnership between states and the federal government; they split the costs, work together to set eligibility guidelines, and partner on this entitlement in other ways. The recent change around work, job training, etc. is not being mandated by the federal government. Rather they are allowing states to implement this as they see fit. That being said, we expect some or all of the following to occur:

There are at least 10 states that have already requested that able bodies adults begin to work. They include Utah, Arizona, Kansas, Arkansas, Indiana, Kentucky, Wisconsin, North Carolina, New Hampshire and Maine. We would expect many other Republican leaning and conservative states to also start to make changes to Medicaid. Note there are currently 34 states in which a republican is governor.

If a state requests changes (also known as a Waiver to the program) then the federal government is saying they can do the following. First of all, tt will impact non-disabled Medicare beneficiaries who range in age from 19-64. They will need to do some type of activity at minimum 20 hours per week. This can include a job. If they can’t work for some reason, then the Medicaid beneficiary will need to be enrolled in a job training program. Or they can volunteer, care for an elderly person, or participate in some other type of state approved activity.

As many know, many Medicaid beneficiaries are battling an addiction, mostly Opioids. So even if they are otherwise able bodied, they may not be able to hold down a job. In these cases, the federal government CMS, as well as local states, may require the addict to enroll into some type of treatment program if they want to continue to receive their Medicaid benefits.

This is a major change to the program, and it is expected to be rolled out quickly. Of the 10 states listed above, the CMS may allow the states to start to make this changes within a matter of days…if not weeks. If you are currently an able-bodied adult, who is not “contributing” to society, and if you live in a Republican leaning state, you better be prepared for this change!


  1. Angela

    I am 53 disabled Divorced & live alone. I have been very ill as well my Mother took her own life. I have Medicaid which since the beginning of 2020 has changed their Prescription Medication provider & I am having to pay from my own prescriptions. I do not work.
    I have to stay on my medications or I will really have problems. I have had an injury to my back 3 compressed disc with a bulging fast growing tumor between a fourth compressed disc. I had a failed surgery on my left foot and the Podiatrist kept me in an air boot almost a year. Causing me to walk and over use my right side. This caused me to not work. I had a fall on stairs at my apartments and a few days the pain increased over a few days. I went to Emergency Room and xrays were taken. The Dr there said all xrays and injuries all were exact to my explanation of the surgery & every incident after. He also said my right hip is so over used and is bone on bone. And I need a hip replacement. I am trying to get First Care Medicaid. I have Amerigroup with Medicaid and the doctor said I deserve the much better coverage of First Care Medicaid. I am unable to pay my rent to Modern Manor Apartments. I am in 22 and very late. My electric bill has notified me of a disconnect. I have such mobility problems that Medicaid is trying to help with. I am most of the time bedridden. I need help with rent $459. My electric bill is notified to be disconnected December 18 2020. The bill is $311.51. Please help me I have no family or friends here and live alone. I am in a crisis and find myself in an emergency situation.

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