Legislative Brief
House Bill 491 / Senate Bill 403: Medicaid work requirements
Putting people’s health care at risk
SB 403/HB 491 Summary: Requires the NC Department of Health and Human Services to begin the process of establishing work requirements for Medicaid once there is any indication that the federal program is considering authorizing work requirements as a condition of participation in the program.
Work requirements in Medicaid would put the health insurance coverage of 1.4 million North Carolinians at risk
- The majority of people receiving Medicaid who can work, do. There is no evidence that work requirements help move people out of poverty or increase employment in the long term.[1]
- In fact, research finds the opposite to be true: higher investments in the Medicaid program and its benefits encourage people to move to better jobs and access higher wages.[2]
- Work requirements lead even people who are working to lose coverage because of red tape related to reporting requirements.[3]
Acting on potential federal policies creates administrative work that may be unnecessary or require adjustment
- Congressional budget resolutions are proposing cuts to Medicaid that could include taking health care coverage away from people who don’t meet the unnecessary and burdensome requirements to report on work activities. However, these federal decisions are not yet final, and this legislation would require North Carolina to lay the groundwork for work requirements regardless of Congress’ final decision.
More about SB 403/HB 491
- Requires NC DHHS to begin negotiations with Center for Medicaid and Medicare (CMS) to plan for work requirements and seek approval for a plan if there is “any indication” that CMS may authorize work requirements for Medicaid.
- Notifies the Joint Legislative Oversight Committee on Medicaid and the Fiscal Research Division within 30 days of the start of negotiations with CMS and within 30 days of CMS’s approval of a plan. Notification includes any necessary administrative and funding requirements for implementation.
- Implements work requirements approved by CMS.
[1] https://www.cbpp.org/research/health/medicaid-work-requirements-could-put-36-million-people-at-risk-of-losing-health
[2] https://econofact.org/does-increased-access-to-medicaid-stimulate-job-mobility
[3] https://www.kff.org/medicaid/issue-brief/understanding-the-intersection-of-medicaid-and-work-an-update/
