Congress is considering major cuts to Medicaid. This is the first in a series of blog posts designed to share resources to help understand what’s at stake.
Medicaid – known as HUSKY in Connecticut – is a critical source of health care coverage for more than one in five state residents. That’s more than 900,000 people – children, seniors, people with disabilities, and low-income adults. The federal government funds about two-thirds of the cost of HUSKY.
One of the changes being considered by members of Congress is to require certain Medicaid clients to report their work hours as a condition of staying covered.
Research on these policies suggests they would cause a lot of people to lose their coverage but would not actually increase employment. That’s because most adults with Medicaid already work, but many could lose coverage anyway because of difficulties reporting their work hours. Similarly, some people who qualify for exemptions to work requirements (for example, if they have disabilities) could still lose coverage because of glitches in the reporting system. That’s what happened in Arkansas when it implemented a work requirement in 2018.
Beyond that, research suggests that Medicaid coverage enables people to work, by allowing those with chronic conditions to get the care they need to stay healthy enough to hold a job. Work requirements would likely hit older adults and people with substance use disorders especially hard.
Want to learn more? Here are some resources on Medicaid work reporting requirements:
The basics
Understanding the intersection of Medicaid and work: An update, KFF, 2025
This provides an overview of Medicaid and work, with data on the work status of Medicaid clients broken down by demographic groups, barriers to work, and state-by-state data.
Know the facts: Medicaid, work, and work requirements, Connecticut Health Foundation, 2025
This fact sheet provides details about work among Medicaid clients in Connecticut, as well as information about states that have tried work requirements.
Medicaid coverage helps people return to work or seek jobs.
Study of Ohio’s Medicaid expansion, The Ohio Department of Medicaid, 2018
Ohio conducted a comprehensive study of its Medicaid expansion (low-income adults without minor children who became eligible as part of the Affordable Care Act).
- In interviews and surveys, “a common theme was that Medicaid enrollment enabled access to treatment for debilitating conditions, thereby making it possible for enrollees to return to work or seek employment.”
- The study authors wrote that there was a strong link between depression and anxiety and being unemployed. “By facilitating treatment for mental health, Medicaid removed barriers to employment readiness and employment retention,” the study said.
Work requirements would likely lead to coverage losses but not increase employment.
Work requirements in Medicaid and other federal programs, Congressional Budget Office, June 2022
This report examines the experiences of work requirements in Medicaid and other federal programs. Among the key findings:
- “States’ limited experience with work requirements in Medicaid indicates that they cause a substantial portion of adults who are not exempt from them to lose coverage, and they appear to have little effect on employment.”
Millions of people could be at risk of losing coverage if work requirements were imposed in Medicaid.
The exact impact of work requirements would depend on how they are designed. Differences could include the age groups and populations subject to the requirement and what level of work and reporting is required.
Medicaid work requirements could put 36 million people at risk of losing health coverage, Center on Budget and Policy Priorities, 2025
- This analysis estimates that 549,000 Connecticut adults would be at risk of losing Medicaid coverage if work requirements were imposed. This represents 51% of HUSKY enrollees as of June 2024.
- This estimate assumes work requirements apply to all adults ages 19 to 64 who are not covered under a portion of Medicaid for people with disabilities.
Assessing potential coverage losses among Medicaid expansion enrollees under a federal Medicaid work requirement, Urban Institute, 2025
- These projections are based on a work requirement for adults ages 19 to 55 covered as part of the Medicaid expansion, using rules set under a 2023 proposal in the U.S. House of Representatives.
- This study projects that 13.3 million adults in the U.S. could be affected by a work reporting requirement in 2026.
- States could reduce coverage losses by using data they already have to determine if people meet the requirement or qualify for an exemption.
- The authors project that between 4.6 million and 5.2 million adults would lose Medicaid eligibility under a work requirement, even though most already work or do work-related activities, or would qualify for an exemption.
Older adults and people with substance use disorders would likely be hit especially hard by work-reporting requirements.
Work requirements would cut Medicaid for older adults, Justice in Aging, 2025
- Nearly 1 in 5 Americans ages 50 to 64 get their health coverage through Medicaid. They face many barriers to working.
- Nearly half (48%) of adults aged 50 to 64 who are covered by Medicaid have a disability, but more than half of them do not receive Supplemental Security Income (which would likely exempt them from work requirements).
- More than 70% of low-income adults aged 50 to 64 have fair or poor health or chronic conditions.
- Older adults are less likely to be employed than younger adults and have a harder time finding work.
- Many older adults are caregivers for relatives or friends, limiting their ability to work.
Imposing Medicaid work requirements could cause many adults with substance use disorders to lose access to treatment, Health Affairs, 2025
Among the key findings of this study:
- Nationally, approximately 9 million people who had substance use disorders were covered by Medicaid in 2023 and would likely be subject to a work reporting requirement if it were implemented.
- About half of those adults had jobs, but many could still lose coverage because of challenges reporting their work hours.
- “[L]oss of access to treatment would make it harder for them to find and retain work in the future, undercutting the stated policy aim of getting this population into the workforce,” the authors wrote.