Washington, DC – The AIDS Institute applauds action taken yesterday by the Biden Administration to rescind the previous administration’s invitation for states to adopt work requirements in Medicaid, and to withdraw approval for the states that took up that invitation. There is substantial evidence that work requirements increase bureaucratic red tape for Medicaid enrollees, resulting in lost coverage and access to care.1 When people living with chronic illness cannot get the care they need, their conditions may worsen, making it even more difficult for them to get or hold down a job. In the case of infectious chronic diseases such as HIV and viral hepatitis, this can also lead to additional viral spread.
?“Medicaid provides coverage for nearly half of adults living with HIV, guaranteeing access to the critical medications that can both prevent and treat HIV,” said Rachel Klein, deputy executive director of The AIDS Institute. “It is also an indispensable source of coverage for people living with viral hepatitis. We cannot end the HIV or hepatitis epidemics in this country unless people who live with and those who are at risk for both HIV and viral hepatitis are able to get the care and treatment they need to keep them healthy. Work requirements undermine those efforts.”
Medicaid work requirements are anathema to the program’s goal of ensuring access to health care for people who cannot otherwise afford it. As states have taken advantage of the opportunity to expand Medicaid created by the Affordable Care Act, racial and ethnic disparities in health insurance coverage have improved, making Medicaid not only crucial for staunching preventable epidemics, but also integral to addressing structural racism.2 And as our nation has battled the economic devastation created by the COVID-19 pandemic, Medicaid has fulfilled its role as a safety net, offering access to both COVID-related and other essential health care for millions of people who lost their jobs and ensuring access to care in this perilous time.3
The administration’s action today will ensure that the Medicaid program can continue to serve as the base for health care initiatives designed to eradicate preventable diseases, such as HIV and viral hepatitis, address racial and ethnic health care disparities, and provide necessary health care for the millions of people in the United States who rely on it.
1Benjamin D Sommers, Lucy Chen, Robert J Blendon, E. John Orav, and Arnold M. Epstein, “Medicaid Work Requirements in Arkansas: Two-Year Impacts on Coverage, Employment, and Affordability of Care,” Health Affairs, Vol. 39, No. 9, September 2020. Available at: https://doi.org/10.1377/hlthaff.2020.00538.
2Jesse Cross-Call, “Medicaid Expansion Has Helped Narrow Racial Disparities in Health Coverage and Access to Care,” October 21, 2020. Available at: https://www.cbpp.org/research/health/medicaid-expansion-has-helped-narrow-racial-disparities-in-health-coverage-and.
3Bradley Corallo and Robin Rudowitz, Kaiser Family Foundation, “Analysis of Recent National Trends in Medicaid and CHIP Enrollment”, January 21, 2020. Available at: https://www.kff.org/coronavirus-covid-19/issue-brief/analysis-of-recent-national-trends-in-medicaid-and-chip-enrollment/#:~:text=After%20declines%20in%20enrollment%20from,enrollment%20began%20to%20steadily%20increase.
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