Are Work Requirements Effective?

Three years ago, Georgia Gov. Brian Kemp signed legislation establishing a new state health plan for low-income citizens in front of a large crowd at the state Capitol.

However, public health experts and advocates argue that since the program’s launch on July 1, state authorities have done virtually nothing to promote or enroll people in the nation’s only Medicaid program that requires users to work.

The Georgia Department of Community Health, which estimated that up to 100,000 people could potentially benefit from Georgia Pathways to Coverage, had approved only 265 applications by early August.

Following the end of the COVID-19 public health emergency, the state formed Pathways and began a review of Medicaid eligibility. During the three-year emergency, states weren’t permitted from removing people from Medicaid.

Georgia has already removed more than 170,000 people and children from Medicaid and expects to remove thousands more as the year-long assessment of all 2.7 million Medicaid beneficiaries in the state continues. More than a million people have been taken off Medicaid across the country, the majority for failing to complete paperwork.

The Centers for Medicare and Medicaid Services (CMS) announced guidelines in January 2018. They 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 employment rules, according to 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 substantial – and presumably disproportionate – effects on people with disabilities.

Past data has shown that work requirements are not successful. According to the state Department of Human Services, in Arkansas there were 265,223 Arkansas Works enrollees, with more than 62,000 of them affected by new work requirements. More than 18,000 people had lost Medicaid coverage by December 2018 because they did not meet the qualifying requirements.

In addition, a study of the Arkansas plan found that a third of the people who were subject to the policy had not heard about it. 44% of the target population was unsure whether the requirements applied to them. 

Medicaid provides essential services to millions of people in this country. People shouldn’t have to choose between their careers and life-saving healthcare services. Everyone should have access to affordable healthcare.


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

Luhby, Tami. “Georgia Is Now the Only State with Work Requirements in Medicaid.” CNN, Cable News Network, 9 Aug. 2023,

Thanawala, Sudhin. “Georgia Medicaid Program with Work Requirement off to Slow Start Even as Thousands Lose Coverage.” AP News, AP News, 19 Aug. 2023,

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