Assessing Medicaid Coverage Losses Under House Reconciliation Bill

Republicans say that able-bodied adults who don’t work would lose Medicaid coverage under the House tax-cuts-and-spending bill, while Democrats say the legislation would hurt vulnerable groups. The bill’s main target is those able-bodied adults, but other groups would lose coverage due to paperwork burdens and other provisions in the bill, health policy experts say.

The majority of coverage losses under the bill would come from those who became eligible for Medicaid due to an expansion of the program under the Affordable Care Act — those enrollees would face new work requirements unless they were subject to an exemption.

“The challenge here is that these work requirements also become sort of a paperwork requirement,” Jennifer Tolbert, deputy director of the Program on Medicaid and the Uninsured at the health policy research group KFF, told us in an interview. In order to keep their Medicaid coverage, people have to document that they’re working the required number of hours or meet the criteria for an exemption. It’s not yet known what kind of documents will be required, she said, but it’s “quite likely that there will be people … who have reported disabilities, who have other chronic conditions, and … who are caring for children or elderly parents, who may also lose coverage” because they aren’t able to provide the correct documents.