Medicaid and Work

The Centers for Medicare and Medicaid Services (CMS) announced guidelines in January 2018 that would allow states to use 1115 Waivers to implement “work and community engagement” requirements for Medicaid beneficiaries.

Adult Medicaid beneficiaries who are 65 or older, pregnant, or qualify for Medicaid because they receive disability benefits under the Supplemental Security Income (SSI) program are exempt from work restrictions, according to the The Centers for Medicare and Medicaid Services. However, approximately three-fifths of all non-elderly adult Medicaid members with disabilities, or nearly five million people, do not receive SSI. As a result, job requirements will continue to have serious – and presumably disproportionate – consequences for people with disabilities.

For example, there were 265,223 Arkansas Works enrollees, more than 62,000 of whom were affected by the new work requirements, according to the state Department of Human Services. By December 2018, more than 18,000 people had lost Medicaid coverage because they did not meet the eligibility requirements.

Conversely, Medicaid is a means-tested program. People can’t earn too much money or have too many assets. Medicaid pays for my PCA services, so I can’t lose coverage. I couldn’t afford to pay for my annual medical expenses out of pocket. My PCA hours cost over $50,000 annually.

Many disabled people have trouble navigating Medicaid and employment. A.J. Kreig has Spinal Muscular Atrophy and uses a wheelchair. Kreig graduated from the University of Minnesota in 2013. Unfortunately, he does not have the opportunity to work full-time as he had intended. He says that despite having a degree, he cannot receive the salary he would like.

PCAs help him get out of bed, bathe, and dress daily. According to a 2022 article, the state of Minnesota pays for Kreig’s services in full. However, he must make $1,113 or less monthly to retain them. That is the official poverty line.

Americans with disabilities should not be forced to live in poverty. Finding accessible, affordable housing shouldn’t be a concern. We should not go to bed hungry, either. Everyone in America, including disabled people, should be able to afford housing and food.

It is antiquated to keep disabled people in poverty. Income and asset limits must be eliminated. Medicaid provides essential services to millions of people in this country including home healthcare, medications, and medical equipment. People shouldn’t have to choose between their careers and life-saving healthcare services.


Bailey, Anna, and Judith Solomon. “Medicaid Work Requirements Don’t Protect People with Disabilities.” Center on Budget and Policy Priorities, Center on Budget and Policy Priorities, 14 Nov. 2018,

Froelich, Jacqueline. “In Arkansas, Thousands of People Have Lost Medicaid Coverage over New Work Rule.” NPR, NPR, 18 Feb. 2019,

Kaye, Steve. How Do Disability and Poor Health Impact Proposed Medicaid Work Requirements? Brandeis University, Feb. 2018, https://doi.org10.48617/rpt.347.

Littlefield, Susan-Elizabeth. “Minnesotans with Disabilities Say State Laws Restrict Financial Freedom.” CBS News, CBS Interactive, 20 Nov. 2022,

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