1.7 Million Could Lose Federal Medicaid Eligibility under Debt Ceiling Legislation

May 8, 2023

Under H.R. 2811, the "Limit, Save, Grow Act of 2023", states would be required to implement work requirements for certain Medicaid, Supplemental Nutrition Assistance Program (SNAP), and Temporary Assistance for Needy Families (TANF) beneficiaries. This legislation, a bill to address the federal debt ceiling and reduce federal spending, was passed by the House of Representatives on April 26, 2023, largely along party lines, by a vote of 217 in favor and 215 opposed. Senate Majority Leader Chuck Schumer (D-NY) has stated that the legislation is Dead on Arrival in the Senate.

The legislation would require states to apply work requirements to able-bodied adults without dependents in the Medicaid program between the ages of 19 and 55, requiring them to either work, engage in community service, or participate in work training programs for at least 80 hours per month to remain eligible for Medicaid benefits. The legislation would also increase the SNAP work requirements age range from 18-49 to 18-55, and would eliminate the ability of states to roll over their unused exemptions from federal work requirements.

A new report from the Kaiser Family Foundation (KFF) has estimated that if H.R. 2811 were signed into law and fully implemented in 2024, then 1.7 million enrollees would not meet work or reporting requirements, and would potentially face disenrollment in that year. The KFF report highlights that 91% of non-elderly Medicaid enrollees who do not receive Supplemental Security Income or Medicare coverage are facing barriers to work.

States would be able to provide coverage without the federal work requirements; however, they would have to pay for the benefits themselves, without any federal funding. The KFF report, "Tough Tradeoffs Under Republican Work Requirement Plan: Some People Lose Medicaid or States Could Pay to Maintain Coverage", estimates that under H.R. 2811, $10.3 billion of Medicaid spending would shift from the federal government to states in 2024, if they chose to disregard the work requirements.

The Congressional Budget Office has estimated that if work requirements were implemented, an average of 15 million enrollees would be subject to the new requirements each year.

Click here to read the KFF report and for more information.

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